Arterial chemotherapy
Intra-arterial chemotherapy
Also known as “Localized Chemotherapy”. Intra-arterial administration of chemotherapeutic drugs is based on the "First Pass" effect, injecting directly into the artery supplying the tumor via a pre-embedded arterial catheter. This is suitable for solid cancers localized to the primary site of the body and locally advanced. For example, head, neck, liver, pancreatic, colorectal, urinary tract, ovarian and endometrial cancer would all be suitable.
According to studies intra-arterial administration could not only deliver high intra-tumoral concentration of drugs, reduce the tumor size and improve the efficacy and patient’s survival but also decrease systemic toxicities compared with intravenous administration. In recent times, intra-arterial chemotherapy has been widely used for cancers in oral cavities to shrink some larger cancers before surgery. In some cases, this makes it possible to use less radical surgery and remove less tissue in order to preserve the individuals’ original appearance and physical functions.
| Local chemotherapy (intra-arterial chemotherapy) | V.S. | Systemic chemotherapy (intravenous chemotherapy) |
|---|---|---|
| Direct administration of chemotherapy drugs to tumors via arterial catheters | Principle of Administration | The chemical is returned to the heart via venous blood vessels and transported from the heart to the whole body. |
| Targets cancers of the head and neck, liver, digestive organs, hands, feet, and sexual organs. | Indications | Suitable for multiple treatments, especially for individuals with high metastatic risk. |
| Chemotherapy drugs are directly infused to cancerous areas. This can relief symptom quickly. The intra-tumoral drug concentration is high, with rapid effects. This helps preserve the structure and function of organs. | Advantages | This administration is simple and rapid. |
| Technical maintenance of the arterial catheter requires expertise. Systemic side effects are mild, preservation of organ function is high, and it can be applied to patients of higher age ranges. | Side effects and risks | Systemic side effects (nausea, vomiting, hair loss, bone marrow suppression, etc.) |
Oral cancer is prevalent among middle-aged men in the country and one of the major public health issues in the world. Currently, it ranks fourth in the most commonly found cancer cases, with more than 6,000 new cases each year. Its high incidence can be attributed to the love of chewing betel nuts, drinking and smoking. Around 15-30% of oral cancer occurs in the lips, and about 1-15% of oral cancer occurs in the joint area between the upper and lower lip. Early oral cancer can be treated with a single treatment, such as surgical resection or radiation therapy to achieve the same effect; unfortunately, most oral cancers are diagnosed at an advanced stage, and if they invade the joints of the lips, a larger amount of treatment is required. It is a complicated process, and its 5-year cure rate is only about 34-50%. Patients with advanced oral cancer are mainly treated with resection of the tumor, which may cause facial damage as well as impaired language and behavior. However, the current use of "intra-arterial administration of chemotherapy" can greatly improve the survival rate, retain the patient’s appearance and physical function, and become a way for patients to avoid surgery. Dean Wu Chih-feng at Kaohsiung Astrid Clinic found that from January 2003 to December 2008, a total of 21 patients with advanced oral cancer of the mouth received intra-arterial administration of chemotherapy. This included 19 males and 2 females, aged between 39 and 75. After 3 months of intra-arterial administration of chemotherapy, the effects were evaluated. In 13 of these patients, the tumors completely disappeared, and in 7 of these patients, the tumors partially disappeared. The overall therapeutic response rate was 95%. Following up an average of 48 months from the treatment, the 3-year and 5-year survival rates were 71% and 64%, respectively, and the 3-year and 5-year survival rates of patients with complete tumor disappearance were 92% and 80%, respectively. Dr. Wu states that the results of the experiment showed that the use of intra-arterial administration of chemotherapy for oral cancer can achieve comparable survival and local control, and the side effects of intra-arterial administration of chemotherapy are mild and tolerable. Most importantly, it can preserve the appearance and facial functions of patients who received treatment to completely remove their tumor. Therefore, intra-arterial administration of chemotherapy can be used as a preferred treatment for oral cancer in the late lip joint.
Many pieces of literature have confirmed that the therapeutic response rate of chemical drugs which are directly injected into the liver by supplying the liver nutrients, is better than that of systemic intravenous injections of drugs, and has far milder side effects. Malignant tumors located in other areas can be treated in this way as long as they can confirm the arteries that supply nutrition.
Highly recommend you to click this link to YouTube and watch it in full screen (subtitles are in Chinese & English)
https://www.youtube.com/watch?v=9UphcLDPpK4&t=8s
