title: Transcatheter arterial chemoembolization of liver tumors: effects of embolization protocol on injectable volume of chemotherapy and subsequent arterial patency.
abstract: The purpose of this study was to determine whether transcatheter arterial chemoembolization (TACE) protocol affects the total volume of chemotherapy injected into the liver as well as subsequent arterial patency. A total of 160 patients with primary or secondary liver cancer were treated with 3 different chemoembolization protocols at a single institution. Data were analyzed retrospectively. Group 1 (n = 36) consisted of slurry of chemotherapy, oil and polyvinyl alcohol particles (PVA), group 2 (n = 91), chemotherapy and oil followed by PVA, and group 3 (n = 33), chemotherapy and oil followed by Gelfoam pledgets. The total volume of chemotherapy injected into the liver was recorded. Arterial patency was determined during subsequent chemoembolizations. The mean percentage of total intended chemotherapy dose administered was 54.6% for group 1, 75.3% for group 2, and 80.6% for group 3. Arterial patency at follow-up angiography was 56% for group 1, 74% for group 2, and 81% for group 3. The slurry protocol (group 1) significantly reduced arterial patency and injectable volume of chemotherapy during TACE.
authors.affiliation: The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, Maryland 21287, USA.
authors.forename: Jean-Francois H
authors.initials: JF
authors.lastname: Geschwind
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Ramsey
authors.forename: Berry
authors.initials: B
authors.lastname: Cleffken
authors.forename: B C H
authors.initials: BC
authors.lastname: van der Wal
authors.forename: Hicham
authors.initials: H
authors.lastname: Kobeiter
authors.forename: Krishna
authors.initials: K
authors.lastname: Juluru
authors.forename: George G
authors.initials: GG
authors.lastname: Hartnell
authors.forename: Michael A
authors.initials: MA
authors.lastname: Choti
mesh_terms: D015901:Angiography, Digital Subtraction; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002408:Catheters, Indwelling; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation*; D002945:Cisplatin / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007269:Injections, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000503:physiopathology / Q000628:therapy*; D008396:Maryland; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011142:Polyvinyl Alcohol / Q000008:administration & dosage; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D003287:Contrast Media; D006490:Hemostatics; D016685:Mitomycin; D007459:Iodized Oil; D004317:Doxorubicin; D011142:Polyvinyl Alcohol; D002945:Cisplatin