• Investigational A new surgical technique called cryosurgery involves freezing the tumor tissue by placing a
cold probe directly into it. A small tumor that cannot be removed because it is too close to blood vessels or
because of extensive underlying liver disease may be "killed" by this technique. The effectiveness of this
therapy is being evaluated.
Chemotherapy Chemotherapy may result in tumor shrinkage and has the potential to prolong
survival. The standard drug, doxorubicin , may shrink tumors in 15 to 20 percent of patients, but the side effects of this drug, including nausea, vomiting and hair loss, must be weighed against the potential benefits. Other drugs that may decrease the tumor size are 5-fluorouracil, mitomycin-C , etoposide and mitoxantrone , although these have similar side effects to doxorubicin.
These drugs seem to shrink tumors more successfully when administered directly into the liver via the hepatic artery. Although tumors within the liver regress in about 50 percent of patients, the therapy is difficult to give since it must be infused into the liver using mechanical pumps over several days. Because few patients feel better after such therapy and because distant metastases nearly always develop, it is generally not advisable to surgically implant an infusion device into the hepatic artery.
• Investigational There is substantial experience in Asia and at some institutions in the U.S. with a process
called chemoembolization. This involves administering a combination of chemotherapy and colloid particles
directly into the liver tumor via its main (hepatic) artery.
