Transpulmonary chemoembolization

What is transpulmonary chemoembolization?

Transpulmonary chemoembolization is a type of regional chemotherapy that allows for local treatment of lung tumours. It is a minimally invasive therapy for patients with lung cancer and, thanks to its regional application, has a number of advantages as it can reduce the stressful side effects of conventional systemic chemotherapy. Through local application, the chemotherapeutic agent is passed only through the lungs and hence the drug can be dosed much higher. This means that the toxic threshold of the drug can be surpassed, leading to a more intensive attack on the cancer cells. The lack of systemic spread of the drug means that the side effects remain low despite toxic concentrations. As a result, it is a well-tolerated treatment that usually only requires a short outpatient stay.

Who is eligible for TPCE?

Above all, patients with lung cancer that is hard to reach can benefit from the therapy. After all, the procedure can make tumors that are difficult to reach accessible to the chemotherapeutic agent. Even for tumors that have previously proven to be inoperable, TPCE may be an option. To ensure that the treatment is possible, it is also important that the tumor has a good blood supply.

Course of treatment

To plan the treatment, patients' blood values are checked in advance to determine their coagulation status, which is essential for the procedure. After local anesthesia, the procedure is performed and the medication is administered. A catheter is inserted into the pulmonary artery where the segmental arteries are probed under X-ray control and vascular imaging. A so-called balloon catheter is then inserted to administer the chemotherapeutic agent under fluoroscopy. During the procedure, the chemotherapeutic agent and another drug are combined to ensure that the therapeutic agent remains in the tumor for a long time. Embolization interrupts the vascular supply to the tumour and therefore causes the tumour tissue to die because of the reduced oxygen supply to the cancer cells. By blocking the small blood vessels, the medication is concentrated and promotes cell death. By cannulating the pulmonary vessels, a closed circuit is created whilhe the balloon catheter prevents the chemotherapeutic agent from entering the subsequent blood vessels. It is expanded within the vessel and blocks it.

To enhance the therapeutic effect, heat therapy can also be applied. This may further promote the reduction of the tumor mass.

CT scans are taken about two days after the procedure and at longer intervals thereafter to document the success of the treatment and the reduction in the tumor burden and to ensure follow-up care. 

Treatment is given at four-week intervals over several sessions usually. A maximum of two lung segments are usually treated per session. After every treatment, patients are also clinically examined in order to detect and treat any side effects.

Risks and side effects

Transpulmonary chemoembolization is well tolerated and has only minor systemic side effects. In comparison to systemic chemotherapy, patients describe a higher quality of life during treatment. The general risks of a surgical procedure, like bleeding during or after the procedure, inflammation and wound healing disorders, as well as potential allergic reactions to the substances used, cannot be ruled out.

How much does transpulmonary chemoembolization cost?

The cost of regional chemotherapy can range from 40,000 to 50,000 euros and depends on the selected procedure. It is possible to request reimbursement from the statutory health insurance companies, although there is currently no standardized cost coverage for the therapy. Each request for reimbursement is decided individually and is currently under discussion, as the treatment has not yet been incorporated into the benefits catalog of the statutory health insurance funds.

Which doctors and clinics specialize in transpulmonary chemoembolization?

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.
Let us help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of transpulmonary chemoembolization and are looking forward to your inquiry or wish for treatment.