Hepatic arterial infusion

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Hepatic arterial infusion is a method of delivering chemotherapy directly into the hepatic artery, which supplies blood to the liver. This targeted approach allows for a higher concentration of chemotherapy to reach the liver while minimizing systemic side effects. Hepatic arterial infusion is commonly used in the treatment of primary liver cancer, also known as hepatocellular carcinoma, as well as metastatic liver tumors from colorectal cancer.

The procedure involves placing a catheter into the hepatic artery, either surgically or through interventional radiology techniques. The catheter is then connected to a pump that continuously delivers chemotherapy into the artery. This continuous infusion allows for a sustained high concentration of the drug in the liver, which can be more effective in killing cancer cells.

Hepatic arterial infusion has several advantages over systemic chemotherapy. By targeting the liver directly, higher doses of chemotherapy can be used without causing excessive toxicity to the rest of the body. This can lead to better tumor response rates and improved overall survival for patients with liver cancer.

However, hepatic arterial infusion is a specialized procedure that requires expertise in interventional radiology or surgical techniques. Careful monitoring is necessary to ensure the proper delivery of chemotherapy and to manage any potential complications, such as catheter-related infections or liver toxicity.

In addition to its use in primary and metastatic liver cancer, hepatic arterial infusion may also be considered in certain cases of liver metastases from other primary cancers, such as neuroendocrine tumors or pancreatic cancer. The decision to use hepatic arterial infusion is based on factors such as the extent of liver involvement, the response to previous treatments, and the overall health of the patient.

Overall, hepatic arterial infusion is a valuable treatment option for select patients with liver cancer, offering the potential for improved outcomes with reduced systemic side effects. Close collaboration between oncologists, interventional radiologists, and other members of the healthcare team is essential to ensure the safe and effective delivery of this specialized therapy.

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Contributors: Prab R. Tumpati, MD