Regional Chemotherapy (RCT)
Regional chemotherapy (RCT) offers significant advantages for treating certain types of solid tumors by achieving high local drug concentrations with minimal systemic side effects. This innovative approach can lead to significant tumor reduction or complete remission, improving the overall prognosis and quality of life for cancer patients.
Techniques of Regional Chemotherapy
Regional chemotherapy can be administered using various techniques tailored to the specific needs of the patient:
1. Arterial Infusion via Angiocatheter
Process: A catheter is inserted into the femoral artery under local anesthesia and advanced to the tumor site.
Advantage: Minimal intervention required.
Disadvantage: Requires bed rest for 3-4 days.
2. Arterial Infusion via Surgically Implanted Port Catheter
Process: An arterial port catheter is implanted into the vessel supplying the tumor.
Advantage: Allows for repeated treatments without further surgery; patient remains mobile.
Disadvantage: Involves surgical implantation with associated risks.
3. Chemoembolization:
Process: Microparticles block the capillaries in the tumor region, prolonging the exposure of cytostatic drugs.
Advantage: High local concentration of the drug.
Disadvantage: Requires bed rest for 3-4 days.
4. Isolated Perfusion:
Process: An organ or body region is isolated and perfused with high concentrations of cytostatic drugs via an external pump.
Advantage: High local drug concentration, enhanced by hyperthermia and hypoxia.
Disadvantage: Involves surgery and associated risks.
Advantages of Regional Chemotherapy
RCT is particularly effective for:
Advantages of Regional Chemotherapy
- High Local Concentration: Achieves up to 80-fold higher concentrations of cytostatic drugs in the tumor area compared to systemic chemotherapy
- Reduced Systemic Toxicity: Chemofiltration removes excess drugs from the bloodstream, minimizing side effects.
- Improved Quality of Life: Patients often experience fewer side effects such as nausea and vomiting, leading to an overall better quality of life.
RCT can achieve tumor shrinkage or complete regression, making subsequent surgical removal easier and less extensive. The success of the therapy largely depends on the tumor’s vascularization and the ability to maintain high local drug concentrations.
Potential Side Effects of Regional Chemotherapy
Although RCT generally causes fewer systemic side effects than traditional chemotherapy, patients may still experience localized side effects, such as:
- Pain or swelling at the infusion site
- Localized tissue damage
- Blood clots or infection
- Temporary loss of function in the treated area (e.g., limb in ILP)
RCT VS. Systemic Chemotherapy
Limitations:
- Localized Treatment: RCT is most effective for localized or regionally confined cancers. It is not suitable for treating metastatic cancer that has spread throughout the body.
- Specialized Care: Administering RCT requires specialized equipment and expertise, so it is usually available only at certain cancer centers.
Frequently Asked Questions
The number of RCT treatments depends on the cancer type, stage, and response to treatment. Some patients may require multiple sessions spaced over several weeks or months.
RCT itself is not usually painful, but patients may experience discomfort from the catheter insertion or minor pain in the treated area. Pain is generally manageable with medication.
Recovery time varies depending on the procedure and the patient’s condition, but most patients can resume normal activities within a few days to a week after treatment.
Some forms of RCT, like hepatic arterial infusion and isolated limb perfusion, may be covered by insurance for specific cancers. Coverage varies, and patients should consult their insurance providers.
Hepatic arterial infusion is a type of RCT that delivers chemotherapy directly to the liver through the hepatic artery, often used for liver metastases or primary liver cancer.
