醫學研究

Advances in the interventional therapies for hepatocellular carcinoma

Cho CC, Hui JW, Yu SC. From inflammation to cancer: advances in diagnosis and therapy for gastrointestinal and hepatological diseases. Singapore: World Scientific Publishing Company; c2012. Chapter 9, Advances in the interventional therapies for hepatocellular carcinoma; p. 205-219.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Surgical treatment, including hepatic resection and liver transplantation, is the most effective therapy and is considered potentially curative. However, less than 20% of HCC can be treated surgically because of multicentric tumors, early vascular invasion, extra hepatic metastasis, shortage of donor organs, poor hepatic reserve or other co-morbidities precluding major surgery. In such instances, a variety of interventional treatments can be offered in order to improve the prognosis of the patient.

Introduction

It is generally accepted that for patients with few and small tumors, local ablation therapies are ideal, provided that there is adequate hepatic reserve. There is a wide variety of minimally invasive ablative therapies available, although radiofrequency ablation (RFA) is currently recognized as the preferred treatment option. Some techniques are relatively novel while other more established therapies are undergoing continual technical advances. In this chapter, focus will be on these newer technologies although more study is required before these become standard treatments or supersede RFA.¹

In cases where the tumor characteristics preclude the patient from surgery or local ablative treatments, i.e. larger and multifocal tumors, patients may choose between transhepatic arterial chemoembolization (TACE) or selective internal radiation therapy (SIRT). Although randomized controlled trials comparing these two modalities are lacking, TACE is the most widely used.1 In the next section, the rationale and efficacy of these two treatments will be described and in particular, more recent advances regarding chemoembolization will be discussed.

Citation:

Cho CC, Hui JW, Yu SC. From inflammation to cancer: advances in diagnosis and therapy for gastrointestinal and hepatological diseases. Singapore: World Scientific Publishing Company; c2012. Chapter 9, Advances in the interventional therapies for hepatocellular carcinoma; p. 205-219.

https://www.webofscience.com/wos/woscc/full-record/WOS:000336528100010