Transarterial Chemoembolisation (TACE) For Liver Cancers Using DC Beads

Pre-consultation Patient information from Sydney Interventional Radiology

Your oncologist has recommended TACE treatment for your liver cancer. Please read this and discuss with your family. Bring this along with you when you come to see us for consultation.

Please bring with you the latest CT scan and your latest blood results. 

What is TACE?

TACE stands for Trans-arterial Chemo-embolisation. Chemotherapeutic drug carried by a blocking agent is delivered directly into the artery supplying the liver tumours. The drug is then slowly released and delivered to the tumour cells in high concentration. The rest of the body is spared from the toxic effect of the drugs. This is a targeted chemotherapy treating the organ containing the tumours without affecting the rest of the body. It is a minimally invasive (non-surgical) procedure performed by an interventional radiologist. TACE has been used to treat primary liver cancer for more than 25 years.

What is DC Bead?  

DC Bead is a drug delivery system for TACE. DC Bead microspheres are produced from a biocompatible polyvinyl alcohol (PVA) hydrogel. DC Bead occludes the blood flow to the target tissue and delivers a local and sustained dose of drug direct to the tumour.

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Who are the candidates for TACE?

Patient who have liver tumours which are not suitable for surgery or ablation, and that systemic oral or IV chemotherapy alone might not be effective. 

Who are not suitable for TACE?

Patients who have more than 75% liver involvement, liver failure, severe liver cirrhosis, extensive metastases outside liver, bone marrow suppression, significant heart, lung and kidney disease. 

What is involved in TACE?

You will be admitted to SAN radiology to have the procedure, and then transferred to a ward for 1-2 nights for observation. The procedure is performed in the angiography suite. The interventional radiologist will place a catheter (small tube) into the artery in the groin, under sedation and local anaesthetic. This catheter will be advanced inside the artery into the liver. Detailed angiograms (road-maps) of the liver are obtained. Non-target arteries branching towards the stomach and duodenum might have to be blocked with tiny metallic coils. This is to prevent collateral damage to the stomach and duodenum. The agents are then injected into the liver artery. When the catheter is removed from your groin, firm pressure will be applied for approximately 10 minutes. For 2-4 hours, you will be asked to lie flat to avoid bleeding from the groin.

Like chemotherapy, a few sessions of TACE are required, usually 3-6 weeks apart.

Are there any side effects from TACE?

All patients will have some degree of post-embolisation syndrome that consists of abdominal pain, low-grade fever, nausea and vomiting. The symptoms are usually worst in the first 24-48 hours and gradually subside over the first week. Medications including a PCA (Patient Controlled Analgesia) pump will be provided. The patients usually live a normal life in between treatments.

What are the potential complications?

Serious complications from TACE are rare. Liver abscess, bile duct injuries, cholecystitis and pancreatitis are potential complications. 

Transient liver dysfunction might be noted in blood test, but chronic liver failure is unlikely, unless the liver is overwhelmed with tumour. We therefore exclude patients with more than 75% tumour involvement in liver. 

Angiograms related complications are very rare. 

Other forms of treatment such as radiotherapy or chemotherapy can also cause a range of mild, moderate, severe or life threatening complications.

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