What are the four types of interventional treatments for mid- to late-stage liver cancer?

  Nowadays, the recognized radical methods for small liver cancer are surgical resection, local ablation and liver transplantation, however, most of the liver cancer in reality are middle and late stage patients. Therefore, when the tumor in the liver is small, usually less than 5cm, it does not feel pain and has no symptoms, therefore, the patient will not take the initiative to check it. Most of the symptomatic hepatocellular carcinoma is in the middle and late stages, and at this time, patients often miss the opportunity of radical treatment, which is very difficult to treat. In addition, liver transplantation is a complicated technique with limited source of liver and long-term anti-rejection drugs after transplantation, which is costly and has many complications.  Therefore, the main goal of treatment for middle and advanced liver cancer is to improve patients’ quality of life, prolong survival time and reduce pain, which is also the disease that we have to try to overcome the most. Appropriate non-surgical resective local minimally invasive therapies are preferred to kill a large number of cancer cells as the central part of comprehensive treatment.  Minimally invasive interventions: 1. hepatic artery chemoembolization (TACE) Percutaneous femoral artery puncture hepatic artery embolization is the treatment of choice for patients with liver cancer that cannot be treated surgically. Its principle is based on the fact that 25% of blood supply to normal liver tissue comes from hepatic artery and 75% from portal vein, while almost all blood supply to liver cancer nodules comes from hepatic artery. Theoretically, if the branch of hepatic artery that provides nutrition to the tumor is cannulated and embolized, it can not only block the blood supply to the cancerous tissue and limit the growth of the tumor, but also cause necrosis and shrinkage of the cancerous tissue without causing liver failure. However, hepatocellular carcinoma must still have portal vein blood supply and hepatic exogenous blood supply, and the blood supply situation is very complicated, such as the blood vessels wrapped by large omentum and the blood vessels on the diaphragm, etc., but interventional embolization is beyond the reach, and the embolized blood vessels of cancer in some people are not as long as people want.  2.Alcohol injection method PEI was developed in 1982, mainly treating small liver cancer. The main mechanism of action is to use anhydrous alcohol to rapidly dehydrate and fix the tumor tissues, causing ischemic necrosis. This method is easy to operate, less painful, less complications and less costly, but it also has side effects such as easy diffusion and liver damage when injected.  3.Percutaneous microwave coagulation therapy (PMCT) is not only applicable to small liver cancer, but also can achieve the effect of eliminating tumor by using the combination of multi-level, multi-needle, multi-point and multi-power time for middle and late stage liver cancer.  4. Permanent inter-tissue implantation of radioactive particles is a new method of liver cancer treatment, which is called “particle knife” by some people in the medical field. It is a minimally invasive method, such as ultrasonic intervention, to directly implant several encapsulated radioisotopes with certain specifications and activity into liver cancer tissues through source applicator or source catheter, and arrange the radioactive sources according to certain rules according to the size and shape of the tumor to irradiate the tumor tissues at a close distance and high dose for the purpose of treatment.