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16 - Transcatheter Arterial Chemoembolization: Technique and Future Potential

from PART III - ORGAN-SPECIFIC CANCERS

Published online by Cambridge University Press:  18 May 2010

By
Eleni Liapi ,
Christos S. Georgiades ,
Kelvin Hong  and
Jean-Francois H. Geschwind
Edited by
Jean-François H. Geschwind  and
Michael C. Soulen
Eleni Liapi
Affiliation:
Postdoctoral Research Fellow, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD
Christos S. Georgiades
Affiliation:
Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD
Kelvin Hong
Affiliation:
Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD
Jean-Francois H. Geschwind
Affiliation:
Professor of Radiology, Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore, MD
Jean-François H. Geschwind
Affiliation:
The Johns Hopkins University School of Medicine
Michael C. Soulen
Affiliation:
University of Pennsylvania School of Medicine
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Summary

Transcatheter arterial chemoembolization (TACE) is one of the most commonly performed procedures in interventional radiology and over the past 20 years, has significantly contributed to the evolution of this subspecialty (1, 2). TACE exploits the initial observation that most hepatic malignancies receive their blood supply largely by the hepatic artery, and selectively delivers intra-arterially high doses of chemotherapy to the tumor bed, while sparing the surrounding hepatic parenchyma (3, 4). Despite its promising design, TACE has not proved yet to be as effective as in theory. Several variations in the application of the technique, as well as the heterogeneity of chemotherapeutic regimens, are some of the most important challenges toward a thorough investigation of its clinical benefits (5). It is therefore essential for interventional radiologists to standardize the technique in order to maximize its effectiveness and help future advancements. In this chapter, we review the technical and clinical part of the procedure, as well as current results and future potential of TACE.

DEFINITION OF TACE, HISTORICAL BACKGROUND AND UNDERLYING PRINCIPLES OF TUMOR DAMAGE

TACE is defined as the infusion of a mixture of chemotherapeutic agents with or without iodized oil followed by embolization with particles (6). The technique was introduced in 1977 by Yamada, who intra-arterially delivered gelatin-sponge pieces permeated with 10 mg of mitomycin C or 20 mg of doxorubicin (Adriamycin), after super-selecting the tumor feeding artery of unresectable hepatomas (3, 4).

Type
Chapter
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Interventional Oncology
Principles and Practice
 , pp. 192 - 201
Publisher: Cambridge University Press
Print publication year: 2008

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  • Transcatheter Arterial Chemoembolization: Technique and Future Potential
    • By Eleni Liapi, Postdoctoral Research Fellow, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Christos S. Georgiades, Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Kelvin Hong, Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Jean-Francois H. Geschwind, Professor of Radiology, Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore, MD
  • Edited by Jean-François H. Geschwind, The Johns Hopkins University School of Medicine, Michael C. Soulen, University of Pennsylvania School of Medicine
  • Book: Interventional Oncology
  • Online publication: 18 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722226.017
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  • Transcatheter Arterial Chemoembolization: Technique and Future Potential
    • By Eleni Liapi, Postdoctoral Research Fellow, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Christos S. Georgiades, Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Kelvin Hong, Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Jean-Francois H. Geschwind, Professor of Radiology, Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore, MD
  • Edited by Jean-François H. Geschwind, The Johns Hopkins University School of Medicine, Michael C. Soulen, University of Pennsylvania School of Medicine
  • Book: Interventional Oncology
  • Online publication: 18 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722226.017
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×

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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Transcatheter Arterial Chemoembolization: Technique and Future Potential
    • By Eleni Liapi, Postdoctoral Research Fellow, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Christos S. Georgiades, Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Kelvin Hong, Assistant Professor, Department of Radiology and Radiological Science Division of Cardiovascular and Interventional Radiology Johns Hopkins University School of Medicine Baltimore, MD, Jean-Francois H. Geschwind, Professor of Radiology, Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore, MD
  • Edited by Jean-François H. Geschwind, The Johns Hopkins University School of Medicine, Michael C. Soulen, University of Pennsylvania School of Medicine
  • Book: Interventional Oncology
  • Online publication: 18 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722226.017
Available formats
×