Hepatic artery infusion and chemoembolization in the management of liver metastases.
Hepatic metastases rather than the primary neoplasm usually dictate the course of the disease and patient's survival. For unresectable disease, intraarterial infusion of chemotherapy, embolization, and chemoembolization are viable alternatives. Intraarterial therapy for hepatic metastases is based on the dual blood supply of the normal liver (portal vein, 75%, and hepatic artery, 25%) and that of the tumors (hepatic artery, 90%). Intraarterial infusion delivers a higher concentration of chemotherapy, whereas chemoembolization adds ischemia and increased contact time with the tumor. Selective vascular occlusion for infusion, redistribution of the blood supply and pulsatile flow enhance the delivery of therapeutic agents to the liver.
Wallace
S
S
Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Carrasco
C H
CH
Charnsangavej
C
C
Richli
W R
WR
Wright
K
K
Gianturco
C
C
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology; D004621:Embolization, Therapeutic; D005134:Eye Neoplasms / Q000473:pathology; D005781:Gelatin Sponge, Absorbable; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008545:Melanoma / Q000473:pathology; D013157:Splenic Artery
D000970:Antineoplastic Agents