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| |  SCVIR MEETING: Chemotherapy Delivered Directly to Liver Tumours Doubles Life Expectancy PHILADELPHIA, PA -- March 24, 1999 -- More than 150,000 new cases of colon cancer are diagnosed each year, and, for half of these patients, the disease spreads to the liver. A Phase-II study performed by a team of researchers at the University of Pennsylvania Medical Center has found that a minimally-invasive technique known as chemoembolization may double the survival time of adult patients with colon cancer that has spread to the liver. Michael Soulen, MD, associate professor of radiology at Penn and senior author of the study, presented these findings today at the 24th annual scientific meeting of the Society of Cardiovascular & Interventional Radiology (SCVIR). Systemic chemotherapy delivers cancer-killing medication into the bloodstream where it travels throughout the body and eventually reaches the tumour. In contrast, chemoembolization works by delivering chemotherapy directly to cancerous cells with the use of a non-surgical, interventional catheterisation technique. This technique also involves the infusion of tiny particles that cut off the blood supply to the tumour, thus inhibiting cancer-cell growth. Colon cancer that has metastasised, or spread, can be managed with chemoembolization when systemic chemotherapy has failed. "Chemoembolization hones in on the cancerous cells that have spread to the liver and avoids exposing the rest of the body to chemotherapy's toxic effects," Dr. Soulen explained. "This technique is not a cure, but it can extend patients' lives and preserve their quality of life." In this study, 51 patients whose colon cancer had metastasised to the liver were treated with chemoembolization. Eighty-six percent, or 44 of the patients, survived one year after treatment. The patients in this study survived an average of two years. Typically, less than half of liver cancer patients survive one year after undergoing systemic chemotherapy. Chemoembolization is performed while the patient is under conscious sedation and is administered by an interventional radiologist. The procedure involves making a small needle puncture in the patient's groin and inserting a catheter, or tiny tube, into the liver's hepatic artery. Using a moving X-Ray, the arteries to the liver are identified and three chemotherapy drugs are delivered directly to the hepatic artery leading to the tumour -- thus sparing healthier liver tissue. The hepatic artery is then blocked off, or embolized, with a mixture of oil and tiny particles. This technique deprives the tumour of fortifying oxygen and nutrients, while saturating the tumour with high doses of medication. Chemoembolization is effective without damaging the liver because the hepatic artery is central to the tumour’s survival, however it provides only 25 percent of the liver's blood supply. The liver is unique in that it has two blood supplies -- a hepatic artery as well as a large portal vein that furnishes ample blood flow on its own. The chemoembolization procedure is approximately three hours in length, and involves an overnight hospital stay. It is performed repeatedly on a monthly basis, with an average treatment regimen of approximately three sessions. "With chemoembolization we can offer a less taxing and effective treatment for liver cancer," Dr. Soulen said. "Although not curative, it can extend and preserve a more normal life for the patient by minimising the cancer and its effects."
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