Chemoperfusion und -embolisation von Lebermetastasen

Zusammenfassung

Vorstellung der Techniken und Indikationsstellungen der regionalen Chemotherapieverfahren in der Behandlung von irresektablen Lebermetastasen verschiedener Primärtumoren im Rahmen des interdisziplinären Therapiemanagements. Zu diesen transarteriellen Therapieverfahren gehören die hepatische arterielle Infusion (HAI) sowie transarterielle Chemoembolisation (TACE), Chemoembolisation mit Zytostatika beladenen Mikrosphären (DEBs), transarterielle Embolisation (TAE) und selektive interne Radiotherapie (SIRT). Regionale Chemotherapieverfahren in der Behandlung der Lebermetastasen stellen eine minimalinvasive Therapieoption dar, die erfolgreich mit chirurgischer Resektion und/oder lokal ablativen Verfahren wie Radiofrequenzablation (RFA), laserinduzierte Thermotherapie (LITT), Mikrowellenablation (MWA) kombiniert werden kann. Diese Verfahren erlauben eine Optimierung lokaler Kontrollrate bei strikt intrahepatischen Prozessen und führen zum Erhöhen der Überlebensraten bei möglichst höherer Lebensqualität.

Abstract

Presentation of techniques and procedures for regional chemotherapy in the treatment of unresectable liver metastases from different primary tumors as a modality of interdisciplinary therapy management. Such transarterial therapy methods include hepatic arterial infusion (HAI), transarterial chemoembolization (TACE), chemoembolization with cytostatic-loaded microspheres (DEBs), transarterial embolization (TAE) and selective internal radiation therapy (SIRT). Regional chemotherapy procedures in the treatment of liver metastases represent a minimally invasive treatment option that can be successfully combined with surgical resection and/or radiofrequency (RFA), laser-induced thermotherapy (LITT), microwave ablation (MWA). These procedures allow optimization of the local control rate with strictly intrahepatic processes and lead to increased survival rates without any quality of life restriction.

Key words

regional chemotherapies - liver metastases - MRI

Literatur

• 1 Pickren J W, Tsukada Y, Lane W W. Liver metastases. Analysis of autopsy data. In Weiss L, Gilbert H A, (Eds) Liver metastases.. Boston: GK Hall Medical; 1982: 2-18
• 2 Bläker H, Hofmann W J, Theuer D et al. Pathologische Befunde bei Lebermetastasen.  Der Radiologe. 2001;  41 1-7
• 3 Edmunson H A, Craig J R. Neoplasms of the liver. Schiff L, (Ed) Diseases of the liver.. Philadelphia: Lippincott; 1987: 1109-1158
• 4 Nizze H, Hebecker R, Strohpahl G et al. Primäre und sekundäre maligne Lebertumore in Autopsie, Biopsie und Zytologie: Häufigkeit und differentialdiagnostische Probleme.  Verh Dtsch Ges Pathol. 1995;  79 137-143
• 5 Neumann U P, Seehofer D, Neuhaus P. Chirurgische Therapie von Lebermetastasen beim kolorektalen Karzinom.  Dtsch Arztebl Int. 2010;  107 335-342
• 6 Jonker D J, Maroun J A, Kocha W. Survival benefit of chemotherapy in metastatic colorectal cancer: a meta-analysis of randomized controlled trials.  Br J Cancer. 2000;  82 1789-1794
• 7 Pool A E, Méndez Romero van der A, Wunderink W et al. Stereotactic body radiation therapy for colorectal liver metastases.  Br J Surg. 2010;  97 377-382
• 8 Seidensticker M, Wust P, Rühl R et al. Safety margin in irradiation of colorectal liver metastases: assessment of the control dose of micrometastases.  Radiat Oncol. 2010;  5 24
• 9 Ricke J, Wieners G, Pech M et al. CT-gesteuerte Brachytherapie versus Laserablation (LITT): Ergebnisse einer match-pair Analyse an identischen Patienten.  Fortschr Röntgenstr. 2006;  S1 178
• 10 Ricke J, Mohnike K, Pech M et al. Local Response and Impact on Survival After Local Ablation of Liver Metastases from Colorectal Carcinoma by Computed Tomography-Guided High-Dose-Rate Brachytherapy.  Int J Radiat Oncol Biol Phys. 2010;  78 479-485
• 11 Brown D B, Geschwind J FH, Soulen M C et al. Society of Interventional Radiology position statement on chemoembolization of hepatic malignancies.  J Vasc Interv Radiol. 2006;  17 217-223
• 12 Vogl T J, Trapp M, Schroeder H et al. Transarterial chemoembolization for hepatocellular carcinoma: volumetric and morphologic CT criteria for assessment of prognosis and therapeutic success – results from a liver transplantation center.  Radiology. 2000;  214 349-357
• 13 Stuart K. Chemoembolization in the management of liver tumors.  Oncologist. 2003;  8 425-437
• 14 Llovet J M, Real M I, Montana X et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial.  Lancet. 2002;  359 1734-1739
• 15 Takayasu K, Arii S, Ikai I et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients.  Gastroenterology. 2006;  131 461-469
• 16 Vogl T J, Zangos S, Eichler K et al. Colorectal liver metastases: regional chemotherapy via transarterial chemoembolization (TACE) and hepatic chemoperfusion: an update.  Eur Radiol. 2007;  17 1025-1034
• 17 Breedis C, Young G. The blood supply of neoplasms in the liver.  Am J Pathol. 1954;  30 969-977
• 18 Vogl T J, Mack M G, Balzer J O et al. Liver metastases: neoadjuvant downsizing with transarterial chemoembolization before laser-induced thermotherapy.  Radiology. 2003;  229 457-464
• 19 Chen H S, Gross J F. Intra-arterial infusion of anticancer drugs: theoretic aspects of drug delivery and review of responses.  Cancer Treat Rep. 1980;  64 31-40
• 20 Wallace S, Carrasco C H, Charnsangavej C et al. Hepatic artery infusion and chemoembolization in the management of liver metastases.  Cardiovasc Intervent Radiol. 1990;  13 153-160
• 21 Wang L Q, Persson B G, Bergqvist l et al. Influence of dearterialization on distribution of absolute tumor blood flow between hepatic artery and portal vein.  Cancer. 1994;  74 2454-2459
• 22 Tancredi T, McCuskey P A, Kan Z et al. Changes in rat liver microcirculation after experimental hepatic arterial embolization: comparison of different embolic agents.  Radiology. 1999;  211 177-181
• 23 Seldinger S I. Catheter replacement of needle in percutaneous arteriography: a new technique.  Acta Radiol. 1953;  39 368-372
• 24 Sullivan R D, Watkins Jr E, Zurek W Z. Cancer chemotherapy by prolonged ambulatory arterial infusion.  Proc Natl Cancer Conf. 1964;  5 543-559
• 25 Collins J M. Pharmacologic rationale for regional drug delivery.  J Clin Oncol. 1984;  2 498-504
• 26 Link K H, Preiß J. Prinzipien der lokoregionalen Therapie. In Schmoll H J,  Höffken K, Possinger K, (eds) Kompendium internistische Onkologie.. Berlin Heidelberg: Springer; 2006: 873-881
• 27 Sumie S, Yamashita F, Ando E et al. Interventional radiology for advanced hepatocellular carcinoma: comparison of hepatic artery infusion chemotherapy and transcatheter arterial lipiodol chemoembolization.  Am J Roentgenol. 2003;  181 1327-1334
• 28 Brown D B, Cardella J F, Sacks D et al. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy.  J Vasc Inter Radiol. 2006;  17 225-232
• 29 Vogl T J, Zangos S, Balzer J O et al. Transarterielle Chemoembolisation (TACE) des hepatozellulären Karzinoms: Technik, Indikationsstellung und Ergebnisse.  Fortschr Röntgenstr. 2007;  179 1113-1126
• 30 Lubienski A, Simon M, Lubienski K et al. Update Chemoperfusion und -embolisation.  Radiologe. 2007;  47 1097-1106, 1108
• 31 Jaeger H J, Mehring U M, Castaneda F et al. Seguential transarterial chemoembolization for unresectable advanced hepatocellular carcinoma.  Cardiovasc Intervent Radiol. 1996;  19 388-396
• 32 Fan J, Thang Z Y, Yu Y Q et al. Improved survival with resection after transcatheter arterial chemoembolization (TACE) for unresectable hepatocellular carcinoma.  Dig Surg. 1998;  15 674-678
• 33 López-Benítez R, Radeleff B A, Barragán-Campos H M et al. Acute pancreatitis after embolization of liver tumors: frequency and associated risk factors.  Pancreatology. 2007;  7 53-62
• 34 Helmberger T. Interventionelle Verfahren bei Lebermetastasen.  Chirurg. 2010;  81 542-550
• 35 Martin R C, Robbins K, Tomalty D et al. Transarterial chemoembolisation (TACE) using irinotecan-loaded beads for the treatment of unresectable metastases to the liver in patients with colorectal cancer: an interim report.  World J Surg Oncol. 2009;  7 80
• 36 Baere de T, Deschamps F, Teriitheau C et al. Transarterial chemoembolization of liver metastases from well differentiated gastroenteropancreatic endocrine tumors with doxorubicin-eluting beads: preliminary results.  J Vasc Interv Radiol. 2008;  19 855-861
• 37 Eyol E, Boleij A, Taylor R R et al. Chemoembolisation of rat colorectal liver metastases with drug eluting beads loaded with irinotecan or doxorubicin.  Clin Exp Metastasis. 2008;  25 273-282
• 38 Tang Y, Czuczman P R, Chung S T et al. Preservation of the active lactone form of irinotecan using drug eluting beads for the treatment of colorectal cancer metastases.  J Control Release. 2008;  127 70-78
• 39 Tang Y, Taylor R R, Gonzalez M V et al. Evaluation of irinotecan drug-eluting beads: a new drug-device combination product for the chemoembolization of hepatic metastases.  J Control Release. 2006;  116 e55-e56
• 40 Grundmann R T, Hermanek P, Merkel S et al. Arbeitsgruppe Workflow Diagnostik und Therapie von Lebermetastasen kolorektaler Karzinome. [Diagnosis and treatment of colorectal liver metastases – workflow].  Zentralbl Chir. 2008;  133 267-284
• 41 Vogl T J, Zangos S, Balzer J O et al. Transarterielle Chemoembolisation von Lebermetastasen: Indikationsstellung, Technik, Ergebnisse.  Fortschr Röngenstr. 2002;  174 675-683
• 42 Kennedy A S, Coldwell D, Nutting C et al. Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience.  Int J Radiat Oncol Biol Phys. 2006;  65 412-425
• 43 Vogl T J, Straub R, Eichler K et al. Moderne Alternativen zur Metastasenresektion – MR-gesteuerte Laser-induzierte Thermotherapie (LITT) und andere local ablative Verfahren.  Ther Umsch. 2001;  58 718-725
• 44 Solbiati L, Goldberg S N, Ierace T et al. Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes.  Radiology. 1997;  205 367-373
• 45 Kemeny N, Niedzwiecki D, Shurgot B et al. Prognostic variables in patients with hepatic metastases from colorectal cancer. Importance of medical assessment of liver involvement.  Cancer. 1989;  63 742-747
• 46 Wagner J S, Adson M A, Van Heerden J A et al. The natural history of hepatic metastases from colorectal cancer. A comparison with resective treatment.  Ann Surg. 1984;  199 502-508
• 47 Bavisotto L M, Patel N H, Althaus S J et al. Hepatic transcatheter arterial chemoembolization alternating with systemic protracted continuous infusion 5-fluorouracil for gastrointestinal malignancies metastatic to liver: a phase 2 trial of the Puget Sound Oncology Concortium (PSOC 1104).  Clin Cancer Res. 1999;  5 95-109
• 48 Germer C T, Buhr H J, Isbert C. Nichtoperative Ablation. Möglichkeiten und Grenzen der Ablationsverfahren zur Behandlung von Lebermetastasen unter kurativer Intention.  Chirurg. 2005;  76 552-554, 556 – 563
• 49 Kennedy A, Nag S, Salem R et al. Recommendations for radioembolization of hepatic malignancies using yttrium-90 microsphere brachytherapy: a consensus panel report from the radioembolization brachytherapy oncology consortium.  Int J Radiat Oncol Biol Phys. 2007;  68 13-23
• 50 Poggi G, Quaretti P, Minoia C et al. Transhepatic arterial chemoembolization with oxaliplatin-eluting microspheres (OEM-TACE) for unresectable hepatic tumors.  Anticancer Res. 2008;  28 3835-3842
• 51 Mulcahy M F, Lewandowski R J, Ibrahim S M et al. Radioembolization of colorectal hepatic metastases using yttrium-90 microspheres.  Cancer. 2009;  115 1849-1858
• 52 Hong K, McBride J D, Georgiades C S et al. Salvage therapy for liver-dominant colorectal metastatic adenocarcinoma: comparison between transcatheter arterial chemoembolization versus yttrium-90 radioembolization.  J Vasc Interv Radiol. 2009;  20 360-367
• 53 Kemeny N, Eid A, Stockman J et al. Hepatic arterial infusion of floxuridine and dexamethasone plus high-dose Mitomycin C for patients with unresectable hepatic metastases from colorectal carcinoma.  J Surg Oncol. 2005;  91 97-101
• 54 Kemeny N E, Niedzwiecki D, Hollis D R et al. Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer: a randomized trial of efficacy, quality of life, and molecular markers (CALGB 9481).  J Clin Oncol. 2006;  24 1395-1403
• 55 Tse A N, Wu N, Patel D et al. A phase I study of gemcitabine given via intrahepatic pump for primary or metastatic hepatic malignancies.  Cancer Chemother Pharmacol. 2009;  64 935-944
• 56 Hildebrandt B, Pech M, Nicolaou A et al. Interventionally implanted port catheter systems for hepatic arterial infusion of chemotherapy in patients with colorectal liver metastases: a Phase II-study and historical comparison with the surgical approach.  BMC Cancer. 2007;  7 69
• 57 Lang E K, Brown Jr C L. Colorectal metastases to the liver: selective chemoembolization.  Radiology. 1993;  189 417-422
• 58 Vogl T J, Gruber T, Balzer J O et al. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study.  Radiology. 2009;  250 281-289
• 59 Damjanovic D, Thompson P, Findlay M PN. Evidence-based update of chemotherapy options for metastatic colorectal cancer.  ANZ J Surg. 2004;  74 781-787
• 60 Hurwitz H, Kabbinavar F. Bevacizumab combined with standard fluoropyrimidine-based chemotherapy regimens to treat colorectal cancer.  Oncology. 2005;  69 17-24
• 61 Lawes D, Taylor I. Chemotherapy for colorectal cancer – an overview of current management for surgeons.  Eur J Surg Oncol. 2005;  31 932-941
• 62 Vogl T J, Müller P K, Mack M G et al. Liver metastases: interventional therapeutic techniques and results, state of the art.  Eur Radiol. 1999;  9 675-684
• 63 Gilliams A, Tarantino L, Stefano de G et al. Survival after percutaneous, image-guided. Thermal ablation of hepatic metastases from colorectal cancer.  Dis Colon Rectum. 2000;  43 656-661
• 64 Shankar A, Lees W R, Gilliams A R et al. Treatment of reccurent colorectal liver metastases by interstitial laser photocoagulation.  Br J Surg. 2000;  87 298-300
• 65 Meade V M, Burton M A, Gray B N et al. Distribution of different sized microspheres in experimental hepatic tumours.  Eur J Cancer Clin Oncol. 1987;  23 37-41
• 66 Burton M A, Gray B N, Kelleher D K et al. Selective internal radiation therapy: validation of intraoperative dosimetry.  Radiology. 1990;  175 253-255
• 67 Burton M A, Gray B N, Klemp P F et al. Selective internal radiation therapy: distribution of radiation in the liver.  Eur J Cancer Clin Oncol. 1989;  25 1487-1491
• 68 Gray B N, Burton M A, Kelleher D K et al. Selective internal radiation (SIR) therapy for treatment of liver metastases: measurement of response rate.  J Surg Oncol. 1989;  42 192-196
• 69 Gray B N, Burton M A, Kelleher D et al. Tolerance of the liver to the effects of Yttrium-90 radiation.  Int J Radiat Oncol Biol Phys. 1990;  18 619-623
• 70 Stubbs R, Wickremesekera S. Selective internal radiation therapy (SIRT): a new modality for treating patients with colorectal liver metastases.  HPB. 2004;  6 133-139
• 71 Stubbs R S, O’Brien I, Correia M M. Selective internal radiation therapy with 90Y microspheres for colorectal liver metastases: single-centre experience with 100 patients.  ANZ J Surg. 2006;  76 696-703
• 72 Fiorentini G, Aliberti C, Benea G et al. TACE of liver metastases from colorectal cancer adopting irinotecan-eluting beads: beneficial effect of palliative intra-arterial lidocaine and post-procedure supportive therapy on the control of side effects.  Hepatogastroenterology. 2008;  55 2077-2082
• 73 Hoe A L, Royle G T, Taylor I. Breast liver metastases – incidence, diagnosis and outcome.  J R Soc Med. 1991;  84 714-716
• 74 Mack M G, Straub R, Eichler K et al. Breast cancer metastases in liver: laser-induced interstitial thermotherapy – local tumor control rate and survival data.  Radiology. 2004;  233 400-409
• 75 Kasper H U, Drebber U, Dries V et al. Lebermetastasen: Inzidenz und histogenetische Einordnung.  Z Gastroenterol. 2005;  43 1149-1157
• 76 Bathe O F, Kaklamanos I G, Moffat F L et al. Metastatectomy as a cytoreductive strategy for treatment of isolated pulmonary and hepatic metastases from breast cancer.  Surg Oncol. 1999;  8 35-42
• 77 Vogl T J, Mack M G, Straub R et al. Interventionelle laserinduzierte Thermotherapie von Lebermetastasen des Mammakarzinoms. Methodik und klinische Ergebnisse.  Gynäkologe. 1999;  32 666-674
• 78 Livraghi T, Goldberg S N, Solbiati L et al. Percutaneous radiofrequency ablation of liver metastases from breast cancer: initial experience in 24 patients.  Radiology. 2001;  220 145-149
• 79 Ikeda T, Adachi I, Takashima S et al. A phase I/II study of continous intra-arterial chemotherapy using an implantable reservoir for the treatment of liver metastases from breast cancer: a Japan Clinical Oncology Group (JCOG) Study 9113.  Jpn J Clin Oncol. 1999;  29 23-27
• 80 Li X P, Meng Z Q, Guo W J et al. Treatment for liver metastases from breast cancer: results and prognostic factors.  World J Gastroenterol. 2005;  11 3782-3787
• 81 Pentheroudakis G, Fountzilas G, Bafaloukos D et al. Metastatic breast cancer with liver metastases: a registry analysis of clinicopathologic, management and outcome characteristics of 500 women.  Breast Cancer Res Treat. 2006;  97 237-244
• 82 Schneebaum S, Walker M J, Young D et al. The regional treatment of liver metastases from breast cancer.  J Surg Oncol. 1994;  55 26-31
• 83 Giroux M F, Baum R A, Soulen M C. Chemoembolization of liver metastases from breast carcinoma.  J Vasc Interv Radiol. 2004;  15 289-291
• 84 Eichbaum M H, Kaltwasser M, Bruckner T et al. Prognostic factors for patients with liver metastases from breast cancer.  Breast Cancer Res Treat. 2006;  96 53-62
• 85 Lee M T, Kim J J, Dinniwell R et al. Phase I study of individualized stereotactic body radiotherapy of liver metastases.  J Clin Oncol. 2009;  27 1585-1591. Epub 2009 Mar 2
• 86 Milano M T, Zhang H, Metcalfe S K et al. Oligometastatic breast cancer treated with curative-intent stereotactic body radiation therapy.  Breast Cancer Res Treat. 2009;  115 601-608
• 87 Coldwell D M, Kennedy A S, Nutting C W. Use of yttrium-90 microspheres in the treatment of unresectable hepatic metastases from breast cancer.  Int J Radiat Oncol Biol Phys. 2007;  69 800-804
• 88 Jakobs T F, Hoffmann R T, Fischer T et al. Radioembolization in patients with hepatic metastases from breast cancer.  J Vasc Interv Radiol. 2008;  19 683-690
• 89 Bangash A K, Atassi B, Kaklamani V et al. 90Y radioembolization of metastatic breast cancer to the liver: toxicity, imaging response, survival.  J Vasc Interv Radiol. 2007;  18 621-628
• 90 Benevento A, Boni L, Frediani L et al. Result of liver resection as treatment for metastases from noncolorectal cancer.  J Surg Oncol. 2000;  74 24-29
• 91 Lehnert T, Knaebel H P. Diagnostik und Therapie von Lebermetastasen neuroendokriner Tumoren.  Der Chirurg. 1997;  68 122-131
• 92 Frilling A, Sotiropoulos G C, Li J et al. Multimodal management of neuroendocrine liver metastases.  HPB. 2010;  12 361-379
• 93 Kress O, Wagner H J, Wied M et al. Transarterial chemoembolization of advanced liver metastases of neuroendocrine tumors – a retrospective single-center analysis.  Digestion. 2003;  68 94-101
• 94 Oberg K. Chemotherapy and biotherapy in neuroendocrine tumours.  Curr Opin Oncol. 1993;  5 110-120
• 95 Kvols L K, Moertel C G, O’Connell M J et al. Treatment of the malignant carcinoid syndrome. Evaluation of a long-acting somatostatin analogue.  N Engl J Med. 1986;  315 663-666
• 96 Christante D, Pommier S, Givi B et al. Hepatic artery chemoinfusion with chemoembolization for neuroendocrine cancer with progressive hepatic metastases despite octreotide therapy.  Surgery. 2008;  144 885-893
• 97 Ruutiainen A T, Soulen M C, Tuite C M et al. Chemoembolization and bland embolization of neuroendocrine tumor metastases to the liver.  J Vasc Interv Radiol. 2007;  18 847-855
• 98 Marelli L, Stigliano R et al. Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies.  Cardiovasc Intervent Radiol. 2007;  30 6-25
• 99 Camma C, Schepis F et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials.  Radiology. 2002;  224 47-54
• 100 Llovet J M, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival.  Hepatology. 2003;  37 429-442
• 101 Touzios J G, Kiely J M, Pitt S C et al. Neuroendocrine hepatic metastases: does aggressive management improve survival?.  Ann Surg. 2005;  241 776-783 ; discussion 783 – 785
• 102 Hajarizadeh H, Ivancev K, Mueller C R et al. Effective palliative treatment of metastatic carcinoid tumors with intra-arterial chemotherapy/chemoembolization combined with octreotide acetate.  Am J Surg. 1992;  163 479-483
• 103 Therasse E, Breittmayer F, Roche A et al. Transcatheter chemoembolization of progressive carcinoid liver metastasis.  Radiology. 1993;  189 541-547
• 104 Loewe C, Schindl M, Cejna M et al. Permanent transarterial embolization of neuroendocrine metastases of the liver using cyanoacrylate and lipiodol: assessment of mid- and long-term results.  AJR Am J Roentgen. 2003;  180 1379-1384
• 105 Kennedy A S, Dezarn W A, McNeillie P et al. Radioembolization for unresectable neuroendocrine hepatic metastases using resin 90Y-microspheres: early results in 148 patients.  Am J Clin Oncol. 2008;  31 271-279
• 106 Del Freo A, Fiorentini G, Sanguinetti F et al. Hepatic arterial chemotherapy with oxaliplatin, folinic acid and 5-fluorouracil in pre-treated patients with liver metastases from colorectal cancer.  In Vivo. 2006;  20 743-746
• 107 Sanz-Altamira P M, Spence L D, Huberman M S et al. Selective chemoembolization in the treatment of hepatic metastases in refractory colorectal carcinoma: a phase 2 trial.  Dis Colon Rectum. 1997;  40 770-775
• 108 Telez C, Benson A B, Lyster M T et al. Phase 2 trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature.  Cancer. 1998;  82 1250-1259
• 109 Leichman C G, Jacobson J R, Modiano M et al. Hepatic chemoembolization combined with systemic infusion of 5-fluorouracil and bolus leucovorin for patients with metastatic colorectal carcinoma: A Southwest Oncology Group pilot trial.  Cancer. 1999;  86 775-781
• 110 Wasser K, Giebel F, Fischbach R et al. Transarterielle Chemoembolisation von Lebermetastasen kolorektaler Karzinome mit abbaubaren Stärkepartikeln (Spherex®). Eigene Beobachtungen und Literaturübersicht.  Radiologe. 2005;  45 633-643
• 111 Sharma R A, Van Hazel G A, Morgan B et al. Radioembolization of liver metastases from colorectal cancer using yttrium-90 microspheres with concomitant systemic oxaliplatin, fluorouracil, and leucovorin chemotherapy.  J Clin Oncol. 2007;  25 1099-1106
• 112 Jakobs T F, Hoffmann R T, Poepperl G et al. Mid-term results in otherwise treatment refractory primary or secondary liver confined tumours treated with selective internal radiation therapy (SIRT) using (90)Yttrium resin-microspheres.  Eur Radiol. 2007;  17 1320-1330
• 113 Vogl T J, Straub R, Eichler K et al. Colorectal carcinoma metastases in liver: laser-induced interstitial thermotherapy – local tumor control rate and survival data.  Radiology. 2004;  230 450-458
• 114 Gillams A R, Lees W R. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation.  Eur Radiol. 2009;  19 1206-1213
• 115 Machi J, Oishi A J, Sumida K et al. Long-term outcome of radiofrequency ablation for unresectable liver metastases from colorectal cancer: evaluation of prognostic factors and effectiveness in first- and second-line management.  Cancer J. 2006;  12 318-326
• 116 Vogl T J, Zangos S, Eichler K et al. Palliative hepatic intraarterial chemotherapy (HIC) using a novel combination of gemcitabine and mitomycin C: results in hepatic metastases.  Eur Radiol. 2008;  18 468-476
• 117 Vogl T J, Naguib N N, Nour-Eldin N E et al. Transarterial chemoembolization (TACE) with mitomycin C and gemcitabine for liver metastases in breast cancer.  Eur Radiol. 2010;  20 173-180
• 118 Meloni M F, Andreano A, Laeseke P F. Breast cancer liver metastases: US-guided percutaneous radiofrequency ablation – intermediate and long-term survival rates.  Radiology. 2009;  253 861-869
• 119 Ho A S, Picus J, Darcy M D et al. Long-term outcome after chemoembolization and embolization of hepatic metastatic lesions from neuroendocrine tumors.  Am J Roentgenol. 2007;  188 1201-1207
• 120 Gupta S, Johnson M M, Murthy R et al. Hepatic arterial embolization and chemoembolization for the treatment of patients with metastatic neuroendocrine tumors: variables affecting response rates and survival.  Cancer. 2005;  104 1590-1602
• 121 Vogl T J, Gruber T, Naguib N N et al. Liver metastases of neuroendocrine tumors: treatment with hepatic transarterial chemotherapy using two therapeutic protocols.  Am J Roentgenol. 2009;  193 941-947
• 122 Rhee T K, Lewandowski R J, Liu D M et al. 90Y Radioembolization for metastatic neuroendocrine liver tumors: preliminary results from a multi-institutional experience.  Ann Surg. 2008;  247 1029-1035
• 123 King J, Quinn R, Glenn D M et al. Radioembolization with selective internal radiation microspheres for neuroendocrine liver metastases.  Cancer. 2008;  113 921-929
• 124 Kalinowski M, Dressler M, König A et al. Selective internal radiotherapy with Yttrium-90 microspheres for hepatic metastatic neuroendocrine tumors: a prospective single center study.  Digestion. 2009;  79 137-142
• 125 Gillams A, Cassoni A, Conway G et al. Radiofrequency ablation of neuroendocrine liver metastases: the Middlesex experience.  Abdom Imaging. 2005;  30 435-441