Chemoembolization and Radioembolization Treatment

Interventional radiology, a rapidly advancing branch of medicine, is the therapeutic section of radiology. In interventional radiology, which is defined as a group of minimally invasive surgical methods, treatments are either a surgical alternative or offered to the patient as treatment methods in cases where surgery cannot be performed.

What is chemoembolization?

In Interventional Radiology, the drug is given intravenously, and since it is 100 times more concentrated, it kills tumor cells much more effectively. There are many methods in Interventional Radiology, but if we talk about embolization in general; Embolization involves treatments performed by reaching the relevant organ through the vein. In fact, embolization means blockage of the vessel. The vessel is blocked, the diseased vessels are closed, but it is not that simple, while blocking the vessels in tumors, it also ensures that the chemotherapeutic drug is trapped inside the tumor at a concentration approximately 100 times higher than when given through the normal systemic route, that is, through the vein. Thus, the chemotherapeutic drug can kill tumor cells much more effectively at a concentration of 100 times within the tumor bed, and since it does not enter the other circulation and is only trapped within the tumor bed, systemic effects are minimal on the patient. Systemic effects; Side effects experienced by the patient after chemotherapy, such as nausea, vomiting, symptoms related to the digestive system, nervous system, and hair loss, do not occur or are minimal in these treatments. The aim of successful treatment is to cause minimal harm to patients and minimal disruption of tissue integrity.

In which diseases is chemoembolization applied?

Embolization performed with chemotherapy drug is called “chemoembolization”. Chemoembolization method is applied to cancerous organs. The liver is one of these organs. In fact, you can use this method in many organs, but currently the organ where the effects of these treatments are most widely proven is the liver. The liver is of course the most critical organ in cancer diseases. Because the liver is the region where cancer diseases most frequently spread. For this reason, liver metastases are the most common cause of death in advanced cancers and the condition that determines the patient’s lifespan. Therefore, chemoembolization is applied for tumors of the liver. It is applied not only for metastases that spread to the liver, but also for tumors originating directly from the liver.

When is chemoembolization performed?

Of course, in medicine there are always algorithms, that is, rankings. These rankings are made by taking into account the situations from which the patient will benefit the most. If surgical removal can be performed for tumors originating from the liver’s own tissue, tumors originating from the liver’s own tissue, and tumors that have metastasized to the liver, this prolongs the patient’s life. This has also been scientifically proven. Of course, this is not the case in all metastases. We have this data here, especially for metastases originating from the intestinal system. As the level of evidence increases as a result of studies on this subject in some other metastases, this information also increases.

If removing the tumor in the liver prolongs the patient’s life, but the size, location, and condition of the tumor prevent surgery, then chemoembolization is used. What is done here actually overlaps with surgical logic.

Does chemoembolization prolong life?

For example, in metastases originating from the intestinal system that metastasize to the liver, almost 30 percent, that is, 1 in 3, of the patients have a metastatic finding at the time the disease is diagnosed. Surgical removal of liver metastases prolongs patient life. This all comes from statistical information accumulated over the years. However, 15-20 percent of patients are suitable for surgical removal of metastases from the liver. In other words, the majority of patients are not suitable for removal of metastases in their liver. In this case, chemoembolization, a method called minimal surgery, may come into play. Currently, great success is being achieved with revolutionary chemotherapy drugs in oncology. But in general, according to statistics, the chemoembolization method increases life expectancy by 20 percent in patients resistant to chemotherapeutic treatments.

What kind of process is it and how long does it take?

This procedure is actually an angiographic procedure. The liver veins are accessed by angiographic method from the groin, and sometimes by entering with a catheter from the arm. After reaching the liver veins, smaller tubes are used to reach the veins that feed the liver and vascular-clogging substances are administered into those veins. This process takes about an hour, although it varies depending on the patient’s condition.

Are there any side effects?

With the development of technology, patients now stay in the hospital for 1 day. After embolization, the patient may experience pain, fever, and nausea. These develop rapidly in the first 24 hours, and a mild flu-like malaise continues for perhaps 1 week to 10 days. However, these side effects are much less compared to a chemotherapy treatment.

How high is the success rate?

With this treatment, the success rate in cancer treatments also increases. Methods and techniques are improving, new drugs are emerging. This not only increases the success, but also progresses with the use of the method together with other chemotherapeutic drugs and the development of new techniques and treatments, as with other drugs.

What is radioembolization?

Radioembolization is also a method applied intravenously. Here, a radiotherapeutic agent is administered into the tumor. So, in a sense, “radiotherapy” is applied inside the body. By entering the body, radiation particles, that is, small particles that emit radiation, are delivered to the tumor. The benefit of this method, compared to externally administered radiotherapy, is that it enters only a limited area of ​​the liver and is applied inside the tumor. External rays can also damage neighboring tissues. The embolization method is applied through the vein, that is, particles that emit radiation are transferred to the tumor bed.

Radioembolization; Apart from liver cancer, it can also be applied to lung tumors, for example. In kidney tumors, embolization can also be performed in cases of excessive bleeding.