Ablative chemoembolization for HCC
Invited conference paper presented and published in conference proceedings



摘要Ablative chemoembolization (ACE) is a new treatment for treating liver cancer. The treatment involves transarterial delivery of a therapeutic formulation that consists of Lipiodol, ethanol, and cisplatin. Lipiodol and ethanol are mixed in a 2:1 ratio by volume to form a stable solution, Lipiodol-ethanol is known to cause embolization and infarction of the tumor following transarterial delivery, because it produces an embolization effect at the vascular level and a chemical ablative effect at cellular level. These two effects are synergistic in causing tumor necrosis because tissue ischemia enhances the diffusion of ethanol from the tumor vasculature to the tumor cells to cause chemical ablation, and the embolization effect of ethanol plays a major role in causing tissue ischemia. A deliverable formulation was prepared with a dose depending on the volume of the tumors, starting with mixing 4 mL of Lipiodol-ethanol solution (2.6 mL Lipiodol and 1.3 mL ethanol) with 20 mg anhydrous cisplatin to create a suspension of 5 mg cisplatin per milliliter of Lipiodol-ethanol. The maximum limiting dose for each treatment session was 100 mg cisplatin in 20 mL Lipiodol-ethanol. The deliverable formulation was delivered through selective catheterization of arterial tumor feeders at segmental or subsegmental level using microcatheters until there was flow stasis at the arterial tumor feeders. If tumor vascularity is still present after the full dose of cisplatin is delivered, embolization of the tumor vasculature was performed through the arterial tumor feeders using Lipiodol-ethanol (33% ethanol by volume), up to 40 mL of Lipiodol-ethanol. Ablative chemoembolization is found to be a feasible and safe treatment that is well tolerated and without complication in preliminary study of 22 patients, it is effective in obtaining complete eradication of the tumor viability of the targeted tumor as represented by a high complete response rate (29/29, 100%), a low intra-tumoral progression rate (1/21, 4.8%), and histopathological proof of no viable residual cancer cells in 6 of 8 tumor specimens.
Ablative chemoembolization is potentially a highly effective treatment to be used as alternative to conventional chemoembolization for HCC in selected patients in whom the tumors are hypervascular and with feeding arteries can be selectively catheterized.
著者Yu Simon Chun-Ho
會議名稱The 3rd Scientific Meeting of Asia-Pacific Association of Image-guided Therapy in Oncology
會議地點Hong Kong
關鍵詞ablative, chemoembolization, hepatocellular carcinoma

上次更新時間 2018-01-11 於 16:55