Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

TACE is intra-arterial injection of a chemotherapeutic drug (e.g. doxorubicin) followed by feeding artery embolization, which leads to a combination of a cytotoxic and ischemiceffect (6).The injection should be continued until vessel-stasis is achieved. TACE is a variable procedure in which different chemotherapeutic drugs, embolic agents, and treatment schedules are applied (7), leading tovariable efficacy outcomes (8). The most commonly used technique is conventional TACE (cTACE) in which a mixture of the cytotoxic drug and lipiodol is injected in the tumoral feeding arteries of HCC, then followed by the embolic agent, e.g. gelatin sponge (gelfoam). Because of the kupffer calls-lack, HCCs retain lipiodol, which will facilitate the retention of the cytotoxic compound as well. However, significant leakage of the chemotherapeutic drug into the systemic circulation has been identified after cTACE (9). In order toavoid this systemic effect, polyvinyl alcohol microparticles loaded with doxorubicinwere developed (10). The microparticlesocclude the feeding arteries while slowly emitting doxorubicin into the tumor, leading to maintained ischemia and prolonged drug effect

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