A combination treatment looks like a better option for some patients with large liver tumors. The treatment includes reducing the size of the tumor before using lasers to heat and destroy the tumor. A new study shows the combination treatment improves the overall survival of the patients.
Radiologists use a procedure called laser-induced thermotherapy (LITT) to heat tumors. The problem is the tumor cannot be too large in order to do this procedure. Doctors say this is especially true for patients with liver tumors. "We see a lot of patients with liver tumors larger than five centimeters (about the size of a golf ball) and in the past we had to refuse them. We needed a way to reduce the tumor to a size where we could perform the laser treatment," says Thomas J. Vogl, M.D., chairman of the Department of Diagnostic and Interventional Radiology at University Hospital in Frankfurt, Germany. Doctors tried a procedure called transarterial chemoembolization (TACE), which involves cutting off the blood supply and using chemotherapy to reduce tumor size.
For the study, researchers used TACE to treat 162 patients with liver tumors. Each patient underwent two to seven TACE treatments to reduce their tumor size. The size of each tumor was measured before and during treatment. Researchers report half of the patients had a successful reduction in their tumor size. In 47 patients, there was no reduction in the size and 33 patients had disease progression.
For the patients who had successful tumor shrinkage, they then underwent the LITT procedure. Researchers say the median survival of the patients who had the combination treatment was more than two years. In patients treated only with TACE, the median survival was just over a year.
Researchers say there is another benefit to this type of treatment. This treatment is local, Dr. Vogl says. "With local chemotherapy, the patients have no pain and don't lose their hair. This treatment allows us to be very aggressive in attacking the tumor, while maintaining a good quality of life for the patient." These procedures are also FDA accepted and researchers say they may be used for other tumors including lung, bone and lymph node tumors.