Totally Percutaneous Hepatic Arterial Infusion Chemotherapy
Totally percutaneous administration of hepatic arterial infusion (HAI) chemotherapy is an alternative to the subcutaneous reservoir pump system used in the United States and much of Europe. This approach has been studied in patients with hepatocellular carcinoma (HCC) and in patients with both primary colorectal cancer and colorectal liver metastases (CRLM). Patients with locally advanced HCC secondary to hepatitis B infection and patients with stage III colorectal cancer seem to have the greatest survival benefit but the percutaneous approach has never been compared head-to-head with the pump-based approach. In this chapter, we present a summary of the existing data that support the use of totally percutaneous HAI chemotherapy in patients with HCC and patients with colorectal cancer with and without liver metastases. We will also briefly discuss the small experiences with other primary and secondary liver tumors.
