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Transarterial treatments in interventional oncology

Arterial treatments

Besides ablation, another group of treatment frequently applied in interventional oncology is arterial or transarterial treatments. The aim of these therapies is first to detect the arteries that feed the tumors with special angiography machines and then to give various substances that kill the tumors through the tiny catheters placed in these arteries. To do the arterial therapies well, it should be clear which arteries feed the tumor and which arteries feed the normal tissue. Otherwise, either the drug may not be given to the tumor and the tumor will be insufficiently treated, or the drug may damage the normal tissue unnecessarily. Although angiography is the classical method used to determine the vessels, the majority of angiography devices used today are insufficient. In interventional oncology, nowadays, the most successful devices for detecting tumor-supplying arteries are special angiography devices that use angiography and computed tomography in combination. In some of these devices, angiography and tomography devices were separately placed in the same space (Combined angiography-tomography systems). In others, the X-ray device used for angiography is also used for tomography (Cone beam tomography systems). The latter is more widely used in the world as these machines are more affordable and practical. 

The most frequently applied arterial treatments in interventional oncology are intraarterial chemotherapy, chemoembolization (TACE) and radioembolization (TARE or Y90). In addition, chemosaturation and isolated chemotherapy infusions are used in some centers but they are still considered experimental. 

Cone beam CT may be advantageous for arterial treatments in cancer.

Interventional oncology in cancer management

Prof Saim Yilmaz, MD

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