Transarterial Chemoembolisation for Colorectal Liver Metastases with the use of Microspheres - A Literature Review

Author(s): Lydia Loutzidou, Ioannis Mantzoros, Sofia Iosifidou, Antonia Aikaterini Bourtzinakou, Stefanos Bitsianis, Georgios Gemousakakis, Anna Gkiouliava, Dimitrios Kyziridis, Stamatios Aggelopoulos.

Classic arterial chemoembolization (conventional TACE or cTACE) and the combination of TACE with the administration of microspheres (drug-eluding beads-DEB or degradable starch microspheres-DSM) are therapeutic options for patients with colorectal liver metastases. Drug eluding beads form bonds with the chemotherapeutic drug if combined and promote a controlled release into the target vessel. Embolizing agents such as lipiodol or spheres (like Embocept) promote occlusion in the arteries supplying the tumor, thus enhancing the chemotherapeutic effect of the administered drugs and limiting the possible systemic toxic complications. TACE is currently used as palliation or as a preparation stage for surgery in colorectal cancer. Patients eligible are the ones with hepatic tumors non-responding to chemotherapy or recurring. The use of microspheres is effective in controlled diffusion of the chemotherapeutic drug in the targeted area, while limiting systemic complications. The use of TACE (DEB-TACE/ DSM-TACE) is promising for patients not responding in the first or second-line cancer treatments. Its application, however, should be individualized. Further results might arise from the implementation of TACE techniques in clinical trials.