Interventional Radiology - Chemoembolization

Chemoembolization is a method used to deliver chemotherapy medication directly to liver tumors — either primary tumors that originated in the liver, or metastases that migrated to the liver from cancers at other sites. Even in cases where chemoembolization is not curative, this approach may relieve a patient’s symptoms and extend survival.

The procedure is performed  by inserting a catheter into a blood vessel in the patient’s groin and advancing it into the specific artery supplying the liver. The interventional radiologist then injects a dye and visualizes the tumor and blood vessels on an x-ray to determine the condition of the portal vein (a major blood vessel in the liver) and assess blood supply to the tumor.

The IR radiologist  then injects an emulsion of anticancer drugs and radiopaque oil through a catheter selectively placed into the artery feeding the tumor. This mixture keeps a high concentration of medication in contact with the tumor for a period of time longer than that associated with traditional systemic chemotherapy. After the treatment is administered, the catheter is withdrawn, and the patient can usually return home after an overnight stay in the hospital.

Chemoembolization offers several advantages over traditional systemic chemotherapy: Prolonging the time the medication stays in contact with the tumor — up to as much as a month — increases the treatment’s effectiveness. Moreover, because the medication is delivered only to the tumor — rather than administered throughout the patient’s bloodstream — healthy tissues are spared from side effects, allowing doctors to administer dosages that are up to 200 times greater than those used in conventional chemotherapy. The substances that are part of the injected mixture not only hold the medication in place, but also block the blood supply to the tumor — depriving it of oxygen and nutrients and thereby halting its growth.

Chemoembolization is not for every patient with liver tumors. Those who have blockages of the portal vein or of the bile ducts may not be eligible for this form of therapy.