Trans Arterial Chemo Embolisation (TACE) is a treatment for Hepatocellular Carcinoma (HCC) where an anticancer agent is mixed with an embolic agent and delivered via the hepatic artery. Early studies showed improved survival rates for TACE-treated HCC patients compared to controls. Patient selection is important, as TACE is best for patients with preserved liver function. More recently, techniques have improved such as using drug-eluting beads and performing highly selective TACE of tumor-feeding arteries to minimize liver damage while maximizing tumor exposure. Ongoing research continues to refine TACE as a key treatment option for HCC.
1. Trans Arterial Chemo Embolisation for
HepatoCellulare Carcinoma
EUROPEAN UNIVERSITARY DIPLOMA
HEPATIC-PANCREATIC AND BILIARY CANCER
15 December 2014
Dr.Y AJAVON and Pr. M LEWIN
Department of Interventionnal Radiology
Dr Sameh AWAD
4. 1- T cœliaque
2- A Gastriqie Gauche
3- A Splenique
4- A Gastro-épiploique D et G
5- A Hépatique moyenne
(commune)
1
2
3
56
7
8
9
10
11
6- A Gastro-duodénale
7- A Hépatique propre
8- Branche droite de l’AH
9- Sectorielle postérieure (Seg 6
et 7)
10 - Sectorielle antérieure (seg 5 et 8)
11- Branche du seg 4
12- Branche gauche de l’AH (seg 2 et 3)
13- A Gastrique droite (pyélorique)
12
Estomac
13
4
6. Anti-cancer Agent
- Whether an anticancer agent is indispensable for
embolization and if so which agent is the best if needed, is
still controversial.
- (doxorubicin (36%) cisplatin (31%) epirubicin (12%)
7.
8. Doyon : Hepatic arterial embolisation for the treatement
du HCC, Ann Radiol 1974
Vetter: 30 Patients: 1 year survival 59% vs 0 for controls,
3 Child C deceased. » Hepatology 1991
Bismuth: 291 patients: 2 year survival Child A 49%
3 months mortality in 37% with Child C.Am J Surg 1992
First experience of TACE in EU
9. Yamada et al. 120 patients de multinodulaires HCC,
survival at one year : - 44% for TACE , 28% for surgery
Radiologie 1983.
Okamura J. 13 patients before resection: complete
necrosis in 8 , Gan To Kagaku Ryoho, 1983
Ohnishi K. 20 patients of whom 16 had a tumor response
>50%,– 1 year survival 38% in 11 patients w.o. PVT,
Radiology, 1984
First experience of TACE in ASIA
33. Nodule 1
du secteur latéral droit
Nodule 2
du dôme hépatique
CASE 3: selective TACE with DC Beads for tow HCC (man,
77 years old with cirrhosis C Chil B.
MRI befor TACE