3.3.4 Interventional Therapy for Liver Cancer

3.3.4 Interventional Therapy for Liver Cancer

Transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) under ultrasound guidance are considered safe, effective, and repeatable first-line treatments for unresectable hepatocellular carcinoma. The normal liver receives most of its blood supply from the portal vein (80%), whereas hepatocellular carcinoma primarily relies on the hepatic artery (90%–100%). Therefore, injecting embolic agents (such as lipiodol and gelatin sponge) into the hepatic artery can block the tumor’s blood supply, achieving a therapeutic effect [58]. When embolic agents are used in combination with chemotherapeutic drugs, the efficacy is even better: not only does it increase the drug concentration within the tumor tissue, but it also slows down blood flow, prolonging the contact time between the drug and cancer cells. Due to ischemia in the cancer cells, the drugs can more easily enter the cells, thereby killing them and achieving the goal of treating hepatocellular carcinoma [59]. PEI treatment for hepatocellular carcinoma features minimal trauma and ease of implementation, and has evolved from simple ultrasound-guided ethanol injection to CT-guided procedures involving multiple drugs. Chemotherapeutic agents, radioactive isotopes, and traditional Chinese medicines (such as cantharidin, cinobufotalin, and allicin) can all be used for local tumor injections. According to Guo Jia et al. [60], after PEI treatment, the tumor shrinkage rate in patients with hepatocellular carcinoma can reach 61.5%–87.9%, and the 1-, 2-, and 3-year survival rates for tumors less than 3 cm in diameter are 85.0%, 98.1%, and 80.0%, respectively—outcomes comparable to those of surgical radical resection.