Chieving significant tumor shrinkage in over 80%.  in hepatic artery chemotherapy, the chemotherapy agents are given into the hepatic artery, often by steady infusion over hours or even days. Compared with systemic chemotherapy, a higher proportion of the chemotherapy agents are (in theory) delivered to the lesions in the liver.  hepatic artery chemoembolization (hace), sometimes called transarterial chemoembolization (tace), combines hepatic artery embolization with hepatic artery chemoinfusion: embospheres bound with chemotherapy agents, injected into the hepatic artery, lodge in downstream capillaries. The spheres not only block blood flow to the lesions, but by halting the chemotherapy agents in the neighborhood of the lesions, they provide a much better targeting leverage than chemoinfusion provides. Selective internal radiation therapy (sirt)  for neuroendocrine metastases to the liver  delivers radioactive microsphere therapy (rmt) by injection into the hepatic artery, lodging (as with hae and hace) in downstream capillaries. generic viagra india In contrast to hormone-delivered radiotherapy, the lesions need not overexpress peptide receptors. The mechanical targeting delivers the radiation from the yttrium-labeled microspheres selectively to the tumors without unduly affecting the normal liver.  this type of treatment is fda approved for liver metastases secondary to colorectal carcinoma and is under investigation for treatment of other liver malignancies, including neuroendocrine malignancies.   other therapies radiofrequency ablation (rfa) is used when a patient has relatively few metastases. [ citation needed ] in rfa, a needle is inserted into the center of the lesion and current is applied to generate heat; the tumor cells are killed by cooking. cheap viagra online Cryoablation is similar to rfa; an endothermic substance[ citation needed ] is injected into the tumors to kill by freezing. Cryoablation has been considerably less successful for gep-nets than rfa. [ citation needed ]  references ^ a b c d e f g h i j k l m n o ramage jk, davies ah, ardill j, et al. (jun 2005). "guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours". Gut. viagra bayer test 54 suppl 4 (suppl_4): iv1â€“16. Doi:10. why are there two bathtubs in the viagra commercial 1136/gut. viagra coupon 2004. viagra bayer test 053314. Pmc 1867801. Pmid 15888809. ^ a b langley, k. (1994). "the neuroendocrine concept today". Annals of the new york academy of sciences 733: 1â€“17. Doi:10. 1111/j. 1749-6632. 1994. Tb17251. buy viagra online X. Pmid 7978856. edit ^ a b c d e f modlin, i. M. viagra safe for 20 year olds ; shapiro, m. generic viagra canada D. ; kidd, m. cheap viagra (2004). "siegfried oberndorfer: origins and perspectives of carcinoid tumors". Human pathology 35 (12): 1440â€“1451. Doi:10. 1016/j. Humpath. 2004. 09. 018. Pmid 15619202. edit ^ a b c d e arnold r, gã¶ke r, wied m, behr t (2003). "chapter 15.
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