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Chemotherapy for liver cancer
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Chemotherapy is treatment with drugs to destroy cancer cells. Systemic (whole body) chemotherapy uses anti-cancer drugs that are injected into a vein or given by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment potentially useful for cancers that have spread to distant organs. The chemotherapy is recommended to treat primary or secondary liver cancer, gallbladder cancer or cholangiocarcinoma (bile duct cancer)--or to shrink the tumor before surgery. Depending on your clinical situation, chemotherapy may be given before, after, or both before and after your surgery. Unfortunately, liver cancer resists most chemo drugs. The drugs that have been most effective in shrinking the tumors are doxorubicin (Adriamycin), 5-fluorouracil, and cisplatin. But even these drugs shrink only a small portion of tumors, and the responses often do not last long. Even with combinations of drugs, in most studies systemic chemotherapy has not helped patients live longer. Our multidisciplinary approach involves medical and surgical oncologists working together closely. We frequently use chemotherapy to prepare patients who may not be considered for surgery at other institutions so they can become candidates for surgery at our Liver Cancer Center.
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Hepatic artery infusion
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Because of the poor response to systemic chemotherapy, it was studied to put chemo drugs directly into the hepatic artery to see if it might be more effective. This technique is known as hepatic artery infusion (HAI). The chemo goes into the liver through the hepatic artery, but the healthy liver breaks down most of the drug before it can reach the rest of the body. This gets more chemo to the tumor than systemic chemo without increasing side effects. The drugs most commonly used include floxuridine (FUDR), cisplatin, mitomycin C, and doxorubicin. Early studies have found that HAI is often effective in shrinking tumors, but more research is still needed. This technique may not be useful in all patients because it often requires surgery to insert a catheter into the hepatic artery, an operation that many liver cancer patients may not be able to tolerate.
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