chemoembolisering

Chemoembolisation, sometimes spelled chemoembolisation, is a minimally invasive oncologic procedure that combines localized delivery of chemotherapy with deliberate occlusion of the tumor’s blood supply. It is a form of transarterial embolization designed to maximize tumor exposure to cytotoxic drugs while inducing ischemia.

The procedure is performed by an interventional radiologist via arterial access (usually femoral, occasionally radial). Under imaging guidance, a catheter is advanced into the hepatic artery or branches supplying the tumor. A chemotherapeutic agent such as doxorubicin, cisplatin, or mitomycin C is infused, often mixed with an embolic material like Lipiodol, microspheres, or gelatin sponge. Some variants use drug-eluting beads (DEB-TACE) that release drug over time. The treatment is often repeated in several sessions depending on tumor response and patient tolerance.

Indications include hepatocellular carcinoma, liver-dominant metastases (especially from colorectal primaries or neuroendocrine tumors), and palliation in patients unsuitable for resection or ablation. It may be used as a bridge to liver transplantation or to downsize tumors before other therapies.

Mechanism and outcomes: By combining chemotherapy with arterial blockage, chemoembolisation increases intratumoral drug concentration and reduces blood flow, promoting tumor necrosis. It can achieve objective responses and disease control, particularly in hepatocellular carcinoma, but is typically not curative and recurrences are common.

Risks and considerations: Common adverse effects include post-embolization syndrome (fever, abdominal pain, nausea), transient liver function changes, and risk of infection, non-target embolization, bile duct injury, vascular complications, or kidney injury from contrast. The procedure requires careful patient selection and follow-up imaging.