PDF herunterladen
Semin intervent Radiol 2017; 34(02): 109-115
DOI: 10.1055/s-0037-1602709
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transarterial Chemoembolization and Radioembolization across Barcelona Clinic Liver Cancer Stages

Joseph Titano
1   Department of Radiology, Icahn School of Medicine at Mount Sinai, New York
,
Amir Noor
1   Department of Radiology, Icahn School of Medicine at Mount Sinai, New York
,
Edward Kim
1   Department of Radiology, Icahn School of Medicine at Mount Sinai, New York
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
01. Juni 2017 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Transarterial chemoembolization (TACE) is a well-established treatment for hepatocellular carcinoma (HCC). TACE has a clearly delineated role within the Barcelona Clinic Liver Cancer (BCLC) staging framework, and TACE has been shown to bridge patients to transplantation and to downsize patients' tumor burden to meet transplantation criteria. Radioembolization (RE) also has an evolving role in the treatment of HCC. RE has evidence-based applications across the range of BCLC stages ranging from segmentectomy for patients with solitary lesions not amenable to ablation to lobar therapy for patients with multifocal HCC, and to treatment of advanced disease with portal vein thrombosis. This article aims to elucidate the evidence behind these therapies and to provide a rationale for their utilization across the spectrum of BCLC stages in the treatment of HCC.

Keywords

interventional oncology - transarterial chemoembolization - radioembolization
 

  • References

  • 1 Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999; 19 (03) 329-338
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 2 Forner A, Reig ME, de Lope CR, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis 2010; 30 (01) 61-74
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 3 Yamada R, Kishi K, Sato M. , et al. Transcatheter arterial chemoembolization (TACE) in the treatment of unresectable liver cancer. World J Surg 1995; 19 (06) 795-800
    CrossrefPubMedGoogle Scholar
  • 4 Duan X, Zhou G, Han X. , et al. Radiofrequency ablation combined with transcatheter therapy in rabbit VX2 liver tumors: effects and histopathological characteristics. Acta Radiol 2015; 56 (01) 87-96
    CrossrefPubMedGoogle Scholar
  • 5 Kim JW, Shin SS, Kim JK. , et al. Radiofrequency ablation combined with transcatheter arterial chemoembolization for the treatment of single hepatocellular carcinoma of 2 to 5 cm in diameter: comparison with surgical resection. Korean J Radiol 2013; 14 (04) 626-635
    CrossrefPubMedGoogle Scholar
  • 6 Kim JW, Kim JH, Won HJ. , et al. Hepatocellular carcinomas 2-3 cm in diameter: transarterial chemoembolization plus radiofrequency ablation vs. radiofrequency ablation alone. Eur J Radiol 2012; 81 (03) e189-e193
    CrossrefPubMedGoogle Scholar
  • 7 Lammer J, Malagari K, Vogl T. , et al; PRECISION V Investigators. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 2010; 33 (01) 41-52
    CrossrefPubMedGoogle Scholar
  • 8 Malagari K, Pomoni M, Moschouris H. , et al. Chemoembolization of hepatocellular carcinoma with HepaSphere 30-60 μm. Safety and efficacy study. Cardiovasc Intervent Radiol 2014; 37 (01) 165-175
    CrossrefPubMedGoogle Scholar
  • 9 Han K, Kim JH. Transarterial chemoembolization in hepatocellular carcinoma treatment: Barcelona clinic liver cancer staging system. World J Gastroenterol 2015; 21 (36) 10327-10335
    CrossrefPubMedGoogle Scholar
  • 10 Burrel M, Reig M, Forner A. , et al. Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design. J Hepatol 2012; 56 (06) 1330-1335
    CrossrefPubMedGoogle Scholar
  • 11 Bouchard-Fortier A, Lapointe R, Perreault P, Bouchard L, Pomier-Layrargues G. Transcatheter arterial chemoembolization of hepatocellular carcinoma as a bridge to liver transplantation: a retrospective study. Int J Hepatol 2011; 2011: 974514
    PubMedGoogle Scholar
  • 12 Graziadei IW, Sandmueller H, Waldenberger P. , et al. Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome. Liver Transpl 2003; 9 (06) 557-563
    CrossrefPubMedGoogle Scholar
  • 13 Kulik L. Criteria for liver transplantation in hepatocellular carcinoma. Clin Liver Dis 2015; 6 (04) 100-102
    CrossrefPubMedGoogle Scholar
  • 14 Riaz A, Gates VL, Atassi B. , et al. Radiation segmentectomy: a novel approach to increase safety and efficacy of radioembolization. Int J Radiat Oncol Biol Phys 2011; 79 (01) 163-171
    CrossrefPubMedGoogle Scholar
  • 15 Padia SA, Kwan SW, Roudsari B, Monsky WL, Coveler A, Harris WP. Superselective yttrium-90 radioembolization for hepatocellular carcinoma yields high response rates with minimal toxicity. J Vasc Interv Radiol 2014; 25 (07) 1067-1073
    CrossrefPubMedGoogle Scholar
  • 16 Vouche M, Habib A, Ward TJ. , et al. Unresectable solitary hepatocellular carcinoma not amenable to radiofrequency ablation: multicenter radiology-pathology correlation and survival of radiation segmentectomy. Hepatology 2014; 60 (01) 192-201
    CrossrefPubMedGoogle Scholar
  • 17 Pompili M, Saviano A, de Matthaeis N. , et al. Long-term effectiveness of resection and radiofrequency ablation for single hepatocellular carcinoma ≤3 cm. Results of a multicenter Italian survey. J Hepatol 2013; 59 (01) 89-97
    CrossrefPubMedGoogle Scholar
  • 18 Livraghi T, Meloni F, Di Stasi M. , et al. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice?. Hepatology 2008; 47 (01) 82-89
    CrossrefPubMedGoogle Scholar
  • 19 Lencioni R, Della Pina C, Bartolozzi C. Percutaneous image-guided radiofrequency ablation in the therapeutic management of hepatocellular carcinoma. Abdom Imaging 2005; 30 (04) 401-408
    CrossrefPubMedGoogle Scholar
  • 20 Chen MH, Wei Y, Yan K. , et al. Treatment strategy to optimize radiofrequency ablation for liver malignancies. J Vasc Interv Radiol 2006; 17 (04) 671-683
    CrossrefPubMedGoogle Scholar
  • 21 Salem R, Vouche M, Habib A, Kim E, Sato KT, Hickey R, Lewandowski R. Reply: To PMID 24691943. Hepatology 2015; 61 (01) 407
    CrossrefPubMedGoogle Scholar
  • 22 Seror O, Nault JC, Nahon P, N'Kontchou G, Trinchet JC. Is segmental transarterial yttrium 90 radiation a curative option for solitary hepatocellular carcinoma ≤5 cm?. Hepatology 2015; 61 (01) 406-407
    CrossrefPubMedGoogle Scholar
  • 23 Tohme S, Sukato D, Chen HW. , et al. Yttrium-90 radioembolization as a bridge to liver transplantation: a single-institution experience. J Vasc Interv Radiol 2013; 24 (11) 1632-1638
    CrossrefPubMedGoogle Scholar
  • 24 Bruix J, Sherman M. ; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011; 53 (03) 1020-1022
    CrossrefPubMedGoogle Scholar
  • 25 Llovet JM, Real MI, Montaña X. , et al; Barcelona Liver Cancer Group. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359 (9319): 1734-1739
    CrossrefPubMedGoogle Scholar
  • 26 Lo CM, Ngan H, Tso WK. , et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35 (05) 1164-1171
    CrossrefPubMedGoogle Scholar
  • 27 Satake M, Uchida H, Arai Y. , et al. Transcatheter arterial chemoembolization (TACE) with lipiodol to treat hepatocellular carcinoma: survey results from the TACE study group of Japan. Cardiovasc Intervent Radiol 2008; 31 (04) 756-761
    CrossrefPubMedGoogle Scholar
  • 28 Ahmadzadehfar H, Meyer C, Ezziddin S. , et al. Hepatic volume changes induced by radioembolization with 90Y resin microspheres. A single-centre study. Eur J Nucl Med Mol Imaging 2013; 40 (01) 80-90
    CrossrefPubMedGoogle Scholar
  • 29 Miyayama S, Yamashiro M, Hashimoto M. , et al. Comparison of local control in transcatheter arterial chemoembolization of hepatocellular carcinoma ≤6 cm with or without intraprocedural monitoring of the embolized area using cone-beam computed tomography. Cardiovasc Intervent Radiol 2014; 37 (02) 388-395
    CrossrefPubMedGoogle Scholar
  • 30 Iwazawa J, Ohue S, Hashimoto N, Muramoto O, Mitani T. Survival after C-arm CT-assisted chemoembolization of unresectable hepatocellular carcinoma. Eur J Radiol 2012; 81 (12) 3985-3992
    CrossrefPubMedGoogle Scholar
  • 31 Lencioni R, Llovet JM, Han G. , et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: the SPACE trial. J Hepatol 2016; 64 (05) 1090-1098
    CrossrefPubMedGoogle Scholar
  • 32 Chapman WC, Majella Doyle MB, Stuart JE. , et al. Outcomes of neoadjuvant transarterial chemoembolization to downstage hepatocellular carcinoma before liver transplantation. Ann Surg 2008; 248 (04) 617-625
    PubMedGoogle Scholar
  • 33 Yao FY, Hirose R, LaBerge JM. , et al. A prospective study on downstaging of hepatocellular carcinoma prior to liver transplantation. Liver Transpl 2005; 11 (12) 1505-1514
    CrossrefPubMedGoogle Scholar
  • 34 Lewandowski RJ, Kulik LM, Riaz A. , et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant 2009; 9 (08) 1920-1928
    CrossrefPubMedGoogle Scholar
  • 35 Salem R, Lewandowski RJ, Kulik L. , et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 2011; 140 (02) 497-507.e2
    CrossrefPubMedGoogle Scholar
  • 36 Iñarrairaegui M, Pardo F, Bilbao JI. , et al. Response to radioembolization with yttrium-90 resin microspheres may allow surgical treatment with curative intent and prolonged survival in previously unresectable hepatocellular carcinoma. Eur J Surg Oncol 2012; 38 (07) 594-601
    CrossrefPubMedGoogle Scholar
  • 37 Kulik LM, Atassi B, van Holsbeeck L. , et al. Yttrium-90 microspheres (TheraSphere) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. J Surg Oncol 2006; 94 (07) 572-586
    CrossrefPubMedGoogle Scholar
  • 38 Kubota K, Makuuchi M, Kusaka K. , et al. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors. Hepatology 1997; 26 (05) 1176-1181
    PubMedGoogle Scholar
  • 39 Shindoh J, Tzeng CW, Aloia TA. , et al. Optimal future liver remnant in patients treated with extensive preoperative chemotherapy for colorectal liver metastases. Ann Surg Oncol 2013; 20 (08) 2493-2500
    CrossrefPubMedGoogle Scholar
  • 40 Vouche M, Lewandowski RJ, Atassi R. , et al. Radiation lobectomy: time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection. J Hepatol 2013; 59 (05) 1029-1036
    CrossrefPubMedGoogle Scholar
  • 41 Zorzi D, Laurent A, Pawlik TM, Lauwers GY, Vauthey JN, Abdalla EK. Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases. Br J Surg 2007; 94 (03) 274-286
    CrossrefPubMedGoogle Scholar
  • 42 Salem R, Mazzaferro V, Sangro B. Yttrium 90 radioembolization for the treatment of hepatocellular carcinoma: biological lessons, current challenges, and clinical perspectives. Hepatology 2013; 58 (06) 2188-2197
    CrossrefPubMedGoogle Scholar
  • 43 Gaba RC, Lewandowski RJ, Kulik LM. , et al. Radiation lobectomy: preliminary findings of hepatic volumetric response to lobar yttrium-90 radioembolization. Ann Surg Oncol 2009; 16 (06) 1587-1596
    CrossrefPubMedGoogle Scholar
  • 44 Jakobs TF, Saleem S, Atassi B. , et al. Fibrosis, portal hypertension, and hepatic volume changes induced by intra-arterial radiotherapy with 90yttrium microspheres. Dig Dis Sci 2008; 53 (09) 2556-2563
    CrossrefPubMedGoogle Scholar
  • 45 Sarpel U, Spivack JH, Berger Y. , et al. The effect of locoregional therapies in patients with advanced hepatocellular carcinoma treated with sorafenib. HPB (Oxford) 2016; 18 (05) 411-418
    CrossrefPubMedGoogle Scholar
  • 46 Li X, Feng GS, Zheng CS, Zhuo CK, Liu X. Expression of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma and effect of transcatheter arterial chemoembolization therapy on plasma vascular endothelial growth factor level. World J Gastroenterol 2004; 10 (19) 2878-2882
    CrossrefPubMedGoogle Scholar
  • 47 Pawlik TM, Reyes DK, Cosgrove D, Kamel IR, Bhagat N, Geschwind JF. Phase II trial of sorafenib combined with concurrent transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma. J Clin Oncol 2011; 29 (30) 3960-3967
    CrossrefPubMedGoogle Scholar
  • 48 Weintraub JL, Salem R. Treatment of hepatocellular carcinoma combining sorafenib and transarterial locoregional therapy: state of the science. J Vasc Interv Radiol 2013; 24 (08) 1123-1134
    CrossrefPubMedGoogle Scholar
  • 49 Bruix J, Raoul JL, Sherman M. , et al. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma: subanalyses of a phase III trial. J Hepatol 2012; 57 (04) 821-829
    CrossrefPubMedGoogle Scholar
  • 50 Llovet JM, Ricci S, Mazzaferro V. , et al; SHARP Investigators Study Group. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359 (04) 378-390
    CrossrefPubMedGoogle Scholar
  • 51 Chern MC, Chuang VP, Liang CT, Lin ZH, Kuo TM. Transcatheter arterial chemoembolization for advanced hepatocellular carcinoma with portal vein invasion: safety, efficacy, and prognostic factors. J Vasc Interv Radiol 2014; 25 (01) 32-40
    CrossrefPubMedGoogle Scholar
  • 52 Luo J, Guo RP, Lai EC. , et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a prospective comparative study. Ann Surg Oncol 2011; 18 (02) 413-420
    CrossrefPubMedGoogle Scholar
  • 53 Lee HS, Kim JS, Choi IJ, Chung JW, Park JH, Kim CY. The safety and efficacy of transcatheter arterial chemoembolization in the treatment of patients with hepatocellular carcinoma and main portal vein obstruction. A prospective controlled study. Cancer 1997; 79 (11) 2087-2094
    CrossrefPubMedGoogle Scholar
  • 54 Georgiades CS, Hong K, D'Angelo M, Geschwind JF. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol 2005; 16 (12) 1653-1659
    CrossrefPubMedGoogle Scholar
  • 55 Kulik LM, Carr BI, Mulcahy MF. , et al. Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 2008; 47 (01) 71-81
    PubMedGoogle Scholar
  • 56 Sato K, Lewandowski RJ, Bui JT. , et al. Treatment of unresectable primary and metastatic liver cancer with yttrium-90 microspheres (TheraSphere): assessment of hepatic arterial embolization. Cardiovasc Intervent Radiol 2006; 29 (04) 522-529
    CrossrefPubMedGoogle Scholar
  • 57 Memon K, Kulik L, Lewandowski RJ. , et al. Radioembolization for hepatocellular carcinoma with portal vein thrombosis: impact of liver function on systemic treatment options at disease progression. J Hepatol 2013; 58 (01) 73-80
    CrossrefPubMedGoogle Scholar
  • 58 Sangro B, Salem R, Kennedy A, Coldwell D, Wasan H. Radioembolization for hepatocellular carcinoma: a review of the evidence and treatment recommendations. Am J Clin Oncol 2011; 34 (04) 422-431
    CrossrefPubMedGoogle Scholar
  • 59 Biederman DM, Titano JJ, Tabori NE. , et al. Outcomes of radioembolization in the treatment of hepatocellular carcinoma with portal vein invasion: resin versus glass microspheres. J Vasc Interv Radiol 2016; 27 (06) 812-821.e2
    CrossrefPubMedGoogle Scholar