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Drug Eluting Beads
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This therapy involves the administration of beads that have been impregnated with the chemotherapy agent. This is a drug delivery system for targeted chemotherapy. These beads are produced from a biocompatible polyvinyl alcohol (PVA) hydrogel. The drug eluting beads are given via catheter directly to the liver tumor just like Transarterial chemoembolization (TACE). Drug eluting beads TACE is a treatment of choice for patients who have liver tumors which are not suitable for surgery or ablation, and that systemic oral or IV chemotherapy alone might not be effective. The interventional radiologist will place a catheter into the artery in the groin, under sedation and local anesthetic. This catheter will be advanced inside the artery into the liver. Detailed angiograms (road-maps) of the liver are obtained. Non-target arteries branching towards the stomach and duodenum might have to be blocked with tiny metallic coils. This is to prevent collateral damage to the stomach and duodenum. The drug eluting beads are then injected into the liver artery. Giving chemotherapy with the beads may provide an additional benefit as the chemotherapy is slowly released from the beads, destroying the tumor over a greater period of time. The drug is locally released which reduces side effects.
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All patients will have some degree of post-embolisation syndrome that consists of abdominal pain, low-grade fever, nausea and vomiting. The symptoms are usually worst in the first 24-48 hours and gradually subside over the first week. Serious complications from TACE are rare. Liver abscess, bile duct injuries, cholecystitis and pancreatitis are potential complications. This approach is not suitable for patients who have more than 75% liver involvement, liver failure, liver cirrhosis, extensive metastases outside liver, bone marrow suppression, significant heart, lung and kidney disease.
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