Chemoembolization is a procedure in which blood supply to the tumor, combined with the effect of chemotherapy, inhibits cancer growth.
There is no standard treatment for liver cancer when surgery, transplantation, or percutaneous treatment is not possible, which applies to around three-quarters of all liver cancer cases.
Arterial embolization - the restriction of blood supply to the tumor - is widely used, but there is uncertainty whether it has a survival benefit.
Conservative treatment: 27%
Jordi Bruix and Josep Llovet from Hospital Clinic, Barcelona, Spain, led a multicenter randomized trial among 112 cirrhotic patients with unresectable liver cancer.
They assessed the survival benefits of arterial embolization (use of gelatin sponge to block blood flow to the tumor) or chemoembolization (gelatin sponge plus the chemotherapeutic drug doxorubicin), compared with conservative treatment.
The trial was stopped when it became apparent that chemoembolization had a substantial survival benefit compared with conservative treatment.
It was found that 25 of 37 patients assigned embolization, 21 of 40 assigned chemoembolization, and 25 of 35 assigned conservative treatment died.
Survival probabilities at 1 year and 2 years were 75% and 50% for embolization, 82% and 63% for chemoembolization, and 63% and 27% for conservative treatment, respectively.
Jordi Bruix comments, "While we wait for confirmatory studies, and from now on, chemoembolization should become the standard approach for the selected group of candidates with unresectable intermediate hepatocellular carcinoma and preserved liver function."