Intrahepatic Chemotherapy/ Chemoembolization

Chemoembolization is the process of injecting chemotherapy drugs through a catheter into the artery that supplies blood to the tumor in your liver. This procedure also is called transcatheter arterial chemoembolization (TACE).

The liver is unique in that it has two blood supplies:

• A large vein — the portal vein — provides about 75 percent of the liver's blood
• An artery — the hepatic artery — contributes 25 percent of the liver's blood

Liver tumors are supplied with blood almost exclusively from the hepatic artery.

By injecting chemotherapy drugs into the hepatic artery, then blocking it off (embolizing) with a mixture of oil and tiny particles, the tumor becomes deprived of oxygen and nutrients.

The liver continues to be supplied with blood from the portal vein.

Benefits of Chemoembolization

• No blood washes through the tumor, so drugs stay in the tumor much longer — for up to one month.
• Since the chemotherapeutic drugs are injected directly at the tumor site, dosages 20 to 200 times greater than standard chemotherapy are injected into a vein in the arm.
• Since drugs are trapped in the liver, instead of circulating throughout the body, most healthy liver tissue is spared and side effects are decreased.

Candidates for Intrahepatic Chemoembolization

This treatment has little or no effect on cancers in other parts of the body, but is ideal for both primary and secondary liver cancers.

The types of liver cancers that may benefit from chemoembolization, include:

• Hepatocellular carcinoma (primary liver cancer)
• Cholangiocarcinoma (bile duct cancer)
• Metastatic liver cancers (carcinoid, ocular melanoma, sarcomas)

Contact the UPMC Liver Cancer Center

To schedule an appointment, or for more information, call the UPMC Liver Cancer Center at 412-692-2001.

What to Expect

Before treatment

Your doctor will conduct several tests before the procedure, including:

• Liver function blood tests
• CT scans
• MRI scans

The doctor checks these test results to rule out complications that could make you a poor candidate for chemoembolization such as:

• Blockage of the portal vein
• Blockage of bile ducts
• Cirrhosis of the liver

The night before your chemoembolization treatment, do not eat or drink anything.

During treatment

When you arrive at the hospital, you will receive an IV line that administers antibiotics and other medications.

Then a radiologist will:

• Place a small catheter in an artery in your groin
• Perform an arteriogram to specifically look at the liver's arteries
• Direct the catheter into the branch of the artery supplying blood to the tumor
• Inject the chemoembolization mixture

After treatment

After this is complete, you will:

• Return to your room, where you will need to lie flat in bed for about 6 hours
• Receive more IV fluids overnight
• Leave the hospital the next day

Side Effects and Risks of Chemoembolization Treatment

The most common side effects of chemoembolization are:

• Pain
• Fever
• Nausea

Some people also notice slight hair loss.

Your symptoms may vary in intensity, but commonly last a few hours to a few days. Ask your doctor about available medicines for minimizing these side effects.

Although there is a small risk of liver failure or infection, serious complications from chemoembolization are rare.