What is minimally invasive interventional therapy for tumors?

I. What is interventional therapy When it comes to “interventional therapy”, many people are unfamiliar with it. Can the treatment be “interventional”? How can tumor be “intervened”? This is the reaction of many patients after hearing the term “interventional therapy” for the first time. “Interventional therapy” is an emerging discipline that has developed rapidly in the past 30 years. It is a technology that uses various fine interventional instruments (mainly puncture needles, slim catheters and guidewires) under the guidance of modern medical imaging equipment to enter the body through tiny incisions or cavity openings in the human skin for diagnosis and treatment. Second, the advantages of interventional treatment 1, minimally invasive (the incision outside the body is only 3-4mm); 2, accuracy, efficiency (accurate positioning, catheter directly delivered to the target vessel); 3, high safety; 4, few complications; 5, short recovery period; 6, repeatability; 7, no destruction of the original anatomical structure and other distinctive disciplinary advantages. It has shown a very broad development prospect and vigorous vitality, and has been recognized by the academic community and the majority of patients. It is not only different from “medicine and injection” in internal medicine, but also different from “open surgery” in surgery. At present, interventional therapeutics is listed as the third major clinical treatment method after surgery and internal medicine, representing the development direction of medicine in the 21st century. The emergence of interventional therapy has solved some of the original “forbidden areas” of medical and surgical treatment. In the treatment of malignant tumor, it also gradually shows its role and becomes an important one among many treatment methods for tumor. The first major feature of interventional therapy is that the catheter can be accurately placed into the artery of tumor blood supply for drug delivery and embolization to combat tumor tissues through interventional therapy. The first major feature of interventional therapy is that the catheter can be accurately placed into the tumor blood supplying arteries for drug delivery and embolization to strike the tumor tissues and cut off the tumor supplying pathways to achieve the purpose of tumor necrosis and shrinkage. 2.Ease the complications caused by tumor by unblocking the “pipeline”. Patients with esophageal cancer will have difficulty in eating progressively, and in serious cases, the esophagus will be blocked, which will affect the intake of nutrition. Patients will have a series of complications such as choking on food, fever, and difficulty in breathing due to lung infection. The patient may have a series of complications such as choking on food, fever, and difficulty in breathing due to pulmonary infection. Stenting” in interventional treatment will effectively relieve the above symptoms, improve the quality of life of patients and provide conditions and time for further treatment. In some tumor diseases, we adopt this method of treatment by placing catheters in the arteries supplying blood to the tumor and burying pumps under the skin. The advantages of this treatment are that the patient can move around during the treatment period without repeated intubation, the cost is relatively low, and it is conducive to shortening the chemotherapy interval. The difference between intravascular chemotherapy and intravenous chemotherapy is explained as follows: 1. The utilization rate of drugs In intravenous chemotherapy, about 1/6 of the total amount of drugs enter the liver, and the remaining 5/6 are distributed in other parts of the body. If we use target intravascular tumor chemotherapy (such as hepatic artery or portal vein chemotherapy), 100% of the drugs will enter the lesion first, and the concentration of drugs in the lesion is tens of times higher than that in intravenous chemotherapy. Even if we reduce the single dose, the concentration of drug at the lesion can be much higher than that of intravenous chemotherapy. Therefore, we can treat tumors by reducing the single dose and shortening the chemotherapy interval. Since chemotherapy efficacy has an important relationship with chemotherapy interval, shortening chemotherapy interval can improve chemotherapy efficacy, so this treatment mode can improve chemotherapy efficacy. We know that the maintenance of effective drug concentration in the body depends on two factors: the dose and the speed of drug administration. Intravenous chemotherapy does not achieve sufficient dose intensity if the single dose is reduced, and does not maintain effective blood concentration if the dosing time is extended. Therefore, intravenous chemotherapy modalities are subject to various limitations. In contrast, intravascular oncology chemotherapy can reduce the single dose to ensure sufficient local dose intensity, and extend the dosing time to meet the local effective drug concentration. Therefore, it can improve the efficacy of tumor treatment and reduce the toxic side effects of chemotherapy. In summary, in view of the differences between the two modes of chemotherapy, intravenous chemotherapy is suitable for patients with systemic tumor dissemination, while intra-target vascular tumor chemotherapy is more suitable for patients with relatively limited tumors. With the progress of modern medical science and technology, the detection of tumors tends to be earlier and earlier, and the proportion of limited stage malignant tumors to all malignant tumors is increasing. Therefore, the clinical application of target intravascular drug therapy is becoming more and more widespread. Indications and contraindications of target endovascular tumor therapy (1) malignant tumors that are sensitive to chemotherapy, such as liver, stomach, pancreas, duodenum and limbs; (2) liver metastases, including colorectal cancer, gastric cancer, esophageal cancer, pancreatic cancer, breast cancer, lung cancer, malignant melanoma and other tumors; (3) some primary liver cancers that are relatively sensitive to chemotherapy. Contraindications】 (1) Patients with severe bleeding tendency; (2) Malignant tumors with extensive systemic metastases; (3) Malignant solid tumors resistant to chemotherapy; (4) Patients with advanced cachexia.