Chemoembolization May Help Some Patients with Inoperable Liver Cancer
Key Words: chemoembolization, liver cancer. (Definitions of many terms related to cancer can be found in the Cancer.gov Dictionary.)
A procedure that uses the drug doxorubicin to help block blood flow to liver tumors improved survival in some patients with inoperable liver cancer, researchers reported in the May 18, 2002, issue of the British journal the Lancet (see the journal abstract).
"These are promising results which suggest that this treatment approach may help a carefully selected group of patients with liver cancer," said Edward L. Trimble, M.D., M.P.H., of the National Cancer Institute's Cancer Therapy Evaluation Program.
Excluded from the study were patients with advanced liver disease other than cancer, as well as those with complications such as kidney failure or the spread of cancer outside the liver. The investigators assessed 908 patients, of whom 112 (12 percent) met the strict criteria for study entry and agreed to take part.
No standard treatment currently exists for liver cancer when tumors cannot be surgically removed and liver transplantation is not a viable option. Most liver cancers are not detected until the disease has reached an advanced stage. Many patients undergo a procedure known as arterial embolization, which uses a gelatin sponge to block blood flow to tumors, but previous studies failed to show whether this procedure could extend the lives of patients.
In the current study, led by Josep M. Llovet of the University of Barcelona Hospital Clinic, a total of 112 patients at three medical centers in Barcelona, Spain, were randomly assigned to receive arterial embolization, chemoembolization, or conservative treatment. Chemoembolization in this trial used the drug doxorubicin in addition to a gelatin sponge to block blood flow to tumors.
The trial was stopped early when it became evident that patients treated with chemoembolization had a significant survival benefit compared to those patients who received conservative treatment. Among patients treated with chemoembolization, 21 of 40 (52.5 percent) died. By contrast, among patients who received conservative treatment, 25 of 35 (71 percent) died. Among those who were treated with arterial embolization, 25 of 37 (67.5 percent) died.
Because the trial was stopped early, a proper analysis comparing the survival benefits of chemoembolization to arterial embolization could not be performed. However, the researchers estimated that 82 percent of patients who received chemoembolization would survive for one year and 63 percent for two years, compared with 75 percent and 50 percent, respectively, of patients who received embolization. They estimated that 63 percent of patients receiving conservative treatment would survive for one year and 27 percent for two years.
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