Chemoembolisation
Chemoembolisation or transarterial chemoembolisation (TACE) is used in the treatment of hypervascularised malignant tumours (for example, primary liver tumours). TACE therapy combines chemotherapy drugs with embolisation.
TACE treatment is administered to patients via a catheter which is usually introduced through the femoral artery and guided to the hepatic artery within the liver. The primary aim of this procedure is to embolise the tumour i.e. to reduce or cut off its blood supply, thus controlling its growth and spread.
Cutting off the blood supply to the liver tumour in this way is possible due to the fact that the liver receives only approximately 25% of its blood supply via the hepatic artery, and the remaining 75% is supplied via the portal vein. The blood supply to a liver tumour is 95% supplied via the hepatic artery. This allows the tumour to be embolised, depriving it of blood, whilst the supply to the remainder of the liver is maintained through the portal vein, and liver function may be preserved.
During TACE, an intra-arterial injection of chemotherapy drug is administered immediately prior to embolisation. The drug is usually mixed with a substance to make it more viscous. The local delivery of the chemotherapy is intended to increase the concentration at the site of the tumour. A higher local concentration increases the effect on the tumour cells, and improves the probability of tumour response compared to systemic chemotherapy. Additionally, this procedure reduces the systemic exposure to the chemotherapy, thus reducing the likelihood of patients experiencing potential side effects related to these potent and toxic chemotherapeutic drugs.