New combined modality appraoch using conformal radiation techniques and direct infusion of chemotherapy drug found to improve lives of terminally ill liver cancer patients.
Surgery remains the most effective treatment option for patients with liver cancer. A cloud of confusion however remains regarding the best way to treat a patient who harbors a liver tumor that cannot be removed by surgery. Infact very little surgical options are currently available for this group of patients.
Thanks to the perseverant work of the researchers who have now suggested a novel plan for combating these tumors using radiotherapy. The radiotherapy is targeted precisely at the tumor and is delivered in combination with chemotherapy approximated to a dose of 400 folds the conventional dose. The radiation oncologists designed a treatment that directly targets the tumor, using conformal radiation techniques that pinpoint precisely where the radiation beams go. This unique approach minimizes the radiation exposure to normal liver tissue.The study was conducted on nearly 128 patients with either cancer of the bile duct, liver or colon that were regarded as inoperable. The study participants received radiation twice daily for two weeks, along with a continuous infusion of the chemotherapy drug floxuridine. The chemotherapy was administered through a catheter into the artery that supplies the liver. A two-week break was allowed before the same regime was continued for another two weeks.
Liver cancers have limited success with radiotherapy owing to the fact that the liver is extremely sensitive to radiation. In addition, multi-drug resistance is a common problem manifested in a majority of the liver cancers. Therefore has not been regarded as a viable option in the treatment strategy.
The study participants had a projected survival rate of eight or nine months. The treatment was found to prolong the survival rate to as much as 15.8 months in a statistically significant way in comparison to the traditional rates. Patients with liver, bile duct and colon cancer were found to live for an average of 15.2, 13.2 and 17.2 months respectively.
Nearly, one third of the treated patients had severe complications ranging from upper gastrointestinal ulcers or bleeding, liver disease to problems associated with the catheter. Research is also underway to further refine techniques for effective delivery of radiation. It has also been proposed to test liver function as a parallel approach to predict the response of the patients to the combined modality approach.
