What is hepatic artery infusion chemotherapy? Hepatic artery infusion chemotherapy is not a new technique for the treatment of liver cancer, but has been used since the 1970s and 1980s. At that time, the infusion of chemotherapeutic drugs was mainly done by hepatic artery cannulation through surgical hepatic artery placement or endovascular intervention techniques. Compared with systemic chemotherapy, infusion of chemotherapy drugs in the hepatic artery can increase the local concentration of drugs in the tumor tissue and reduce the distribution of chemotherapy drugs in other organs, thus producing stronger anti-tumor effects and reducing systemic side effects. Which patients are recommended to have hepatic artery infusion chemotherapy? 1. Hepatic artery infusion chemotherapy is suitable for patients with hepatocellular carcinoma with portal vein thrombosis, especially for patients with hepatic artery-portal vein fistula, or patients with hepatocellular carcinoma who have received traditional interventional treatment but with poor efficacy. 2. Patients with liver metastases from colorectal cancer. 50% of colorectal cancer patients will have liver metastases, but only 15% to 20% of patients with liver metastases can be resected. For those colorectal liver metastases that cannot be resected, using hepatic artery infusion chemotherapy, the local drug concentration of the lesion can reach tens of times of peripheral intravenous chemotherapy, which has the advantages of high local control rate of tumor and small systemic side effects. Moreover, even in regimens where systemic chemotherapy is resistant, local hepatic artery infusion may still be effective. What drugs are used in hepatic artery infusion chemotherapy? In the past, conventional hepatic artery infusion chemotherapy used cisplatin regimens, but studies have shown that the efficacy of cisplatin-based chemotherapy regimens is not satisfactory. The FOLFOX regimen (oxaliplatin, fluorouracil, calcium folinic acid) is the approved systemic chemotherapy regimen for both advanced hepatocellular and colorectal cancers and has demonstrated a survival benefit in patients with both advanced hepatocellular and colorectal cancers. What is the difference between hepatic artery infusion chemotherapy and conventional interventions? Compared to conventional interventions, hepatic artery chemotherapy infusion is administered with much higher doses of chemotherapeutic agents, especially fluorouracil, which is more than three times the dose of conventional interventions. In terms of dosing time, conventional intervention is a short injection of chemotherapy drugs into the hepatic artery, while hepatic artery infusion chemotherapy is a continuous drip of chemotherapy drugs for up to 48 hours. While conventional interventions are basically 1-2 months/course of treatment, hepatic artery infusion chemotherapy is administered in a 3-week/course regimen to maximize the effect of chemotherapy. What are the adverse effects after hepatic artery infusion chemotherapy and how to deal with them? In terms of surgical operation, hepatic artery perfusion may have catheter-related complications, including arterial injury, gastric or duodenal misperfusion, decannulation and blockage, which can be avoided by adjusting the catheter position, properly fixing the catheter and strengthening the catheter heparinization. Due to the addition of larger doses of chemotherapeutic drugs, myelosuppression, manifested as a decrease in white blood cells and platelets, is likely to occur after chemotherapy perfusion, and colony cell-stimulating factor can be injected after chemotherapy to improve bone marrow hematopoietic function. In addition, oxaliplatin tends to cause peripheral neuritis, which can be relieved by oral nerve-nourishing drugs. Adverse effects commonly associated with systemic chemotherapy, such as alopecia, are uncommon in arterial perfusion.