Hepatocellular carcinoma interventional therapy, known as hepatocellular carcinoma interventional therapy, is the least invasive treatment method to treat the lesion locally under the guidance of imaging equipment (angiography, fluoroscopy, CT, MR, B ultrasound) by making tiny channels of several millimeters in diameter in blood vessels or skin without opening the lesion or through the original pipeline of human body.
Among hepatocellular carcinoma, vascular interventional therapy has the most clinical applications. It is mainly selective hepatic artery perfusion therapy, selective hepatic artery embolization, and selective hepatic artery chemoembolization. The main physiological basis is that the blood supply of normal hepatocytes is 20%-25% from hepatic artery and 75%-85% from portal vein. In primary hepatocellular carcinoma, 90%-95% of the blood supply comes from the hepatic artery, which provides the anatomical basis for vascular intervention for hepatocellular carcinoma. The specific technical methods of all three are the same, which is to puncture a small opening of about 3-5mm on the skin, insert a tube from the artery to the blood supplying artery of hepatocellular carcinoma, and then administer the drug through the catheter.
Selective hepatic artery infusion (TAI) therapy
TAI is the intra-arterial infusion of drug through a catheter at a dose equal to or less than that given intravenously. This increases the local drug concentration in the target cells and prolongs the contact time between the drug and the lesion, and reduces the total systemic dose of the drug, thus improving the efficacy and reducing side effects. The efficacy of chemotherapeutic drugs is positively correlated with the effective blood concentration of the drug at the tumor site and the time of drug-tumor contact.
Selective hepatic artery embolization (TAE)
TAE is to selectively inject embolic agent into tumor blood vessels and tumor blood supply arteries through catheter to block tumor blood supply and close tumor blood vessel bed, thus inhibiting tumor growth. This is equivalent to “starving” the tumor to death. Commonly used embolization agents include gelatin sponge, ultra-liquidated iodine oil, sodium alginate microspheres, etc.
Selective hepatic artery chemoembolization (TACE) is the administration of both chemotherapeutic drugs and embolic agents via catheter. The tumor is destroyed by both routes.
Treatment advantages
Liver cancer has become one of the major diseases that endanger the society and human health, and it has brought great pain and distress to human beings. In order to reduce the incidence of liver cancer, liver cancer interventional treatment is very necessary. The advantages of liver cancer interventional treatment are roughly as follows.
1. precise efficacy, successful treatment can see rapid decrease of AFP, shrinkage of mass and pain relief, etc.
2. Mechanistic science: the local drug concentration of interventional therapy is tens of times higher than that of systemic chemotherapy, and the blood supply to the tumor is blocked, so the two-pronged treatment is effective and less toxic than systemic chemotherapy.
3. Interventional treatment for liver cancer is simple and easy to operate, safe and reliable.
4.It can be performed even for the old and frail and those with certain diseases, without general anesthesia and keeping awake.
5.Diagnostic imaging is clear and can be repeated to facilitate multiple comparisons.
6.For some hepatocellular carcinoma, it can be reduced in size and then resected in two steps.
7.It can be used as one of the important means of comprehensive treatment for advanced tumors.
8.The cost of hepatocellular carcinoma interventional treatment is relatively low.
Disadvantages of treatment
1.Despite super-selective access, there are still obvious side effects, with the most gastrointestinal reactions, which bring discomfort to human body.
2.hepatocellular carcinoma mainly relies on hepatic artery for blood supply, but there is portal vein blood supply around the cancer mass, so that cancer cells can survive secretly
The catheter should be super-selected to enter the blood supply artery for better efficacy, but sometimes it is difficult to enter the hepatic artery. But sometimes it is difficult to enter the hepatic artery.