Chemoembolization in oncology
The combined use of cytostatic agents and embolization of blood vessels in medicine is calledchemoembolization. Through this technique, a chemotherapeutic agent is injected through the artery into the affected organ. At the end, the lumen of the vessel is closed with a special embolus. Such treatment is mainly used in cancerous liver tumors.
Indications for chemoembolization
The technique is aimed at point cytotoxic effects on malignant neoplasm and overlapping blood supply to the tumor.
Indications for this therapy are:
- Liver cancer or other primary oncology of liver tissue.
- Metastases to the liver from oncological formations of the gastrointestinal tract, the breast and skin tumors.
Chemoembolization in liver oncology allows to affect only mutated tissues, without harming physiologically healthy cells. This effect is based on the introduction of cytotoxic drugs in the hepatic artery, which by 75% blood supply to cancer pathology. In this case, the body itself receives vital substances through the portal vein system.
Another advantage is the low traumatism of the procedure, which can be performed even in a patient in a difficult general condition.
Doctors do not recommend such treatment in the following cases:
- Acute renal or hepatic insufficiency.
- Patients with abnormalities of blood clotting.
- Chronic obstruction of the biliary tract.
At the same time, many oncological patients with liver dysfunction nevertheless undergo chemoembolization. Only treatment in this case involves the introduction of a minimal dose of a cytostatic agent so as not to damage healthy liver tissue.
How is chemoembolization performed in oncology?
Before the manipulation, the patient undergoes an additional X-ray examination, the purpose of studying is the location of pathological blood vessels.
The patient at this time takes a drug that protects the kidneys from chemotherapy and the intake of a large number of disintegration products of the tumor.
Also, during the preoperative period, it is desirable for the patient to use antibiotics and remedies for the elimination of nausea.
After the above-described preliminary preparation, the oncological patient is located on the operating table. Medical monitors are connected to it to monitor the operation of the cardiovascular system. Also, with the help of intravenous injection, the patient is administered sedatives.
Direct surgical manipulation includes:
- The insertion of a catheter into the femoral artery.
- Promotion of a surgical instrument to a malignant neoplasm, which is carried out under the control of radiography.
- The release of the cytostatic agent and the overlap of the lumen of the blood vessel.
- Removing the catheter from the body.
Operative intervention ends with the laying of a tight bandage at the place of puncture of the skin. Also, the patient should be under the control of medical personnel within 6-8 hours.
Disadvantages and safety
The main disadvantage of such manipulation is the toxic effect on the body and, in particular, on the kidneys.
For the safety of the cancer patient, a thorough diagnosis in the preoperative period is necessary. Also, the positive result of the intervention largely depends on the skill and experience of the surgeon.
Complications of this event can be of the following nature:
- Infectious lesion of the puncture site. The probability of such a process corresponds to all surgical interventions.
- Catheter damage to the inner wall of the blood vessel, which can be exacerbated by internal bleeding and infection.
- Penetration of the embolus into nearby healthy tissues, in which as a result of this microcirculation of blood is disturbed.
- Allergic reaction to the ingredients of contrast medium.
- As with all types of chemotherapy, patients after treatment may experience nausea, vomiting, hair loss, anemia, and a decrease in platelet count.
- Mechanical trauma of kidney tissues and development of acute renal failure. This complication is considered to be the most severe, as it often ends in a fatal outcome.
This innovative method can be carried out only in specialized oncological centers. Its cost depends on the country and the qualification of the operating team.
- In Russia, the transaction price is 130 000 - 160 000 rubles.
- In Ukraine, this intervention can cost 70 000 - 90 000 hryvnia.
- In Germany, the price of manipulation is estimated at , 00 euros.
- In Israelchemoembolizationwill cost the patient $ , 00 - $ , 00.