Transarterielle Therapien bei HCC – ein Überblick anhand der aktuellen S3-Leitlinie

In den Leitlinien zum hepatozellulären Karzinom nehmen die transarteriellen Verfahren eine wichtige Rolle ein und sind im intermediären Stadium oft Mittel der Wahl. Die einzelnen Verfahren wie Radioembolisation und verschiedene Formen der Chemoembolisation werden in diesem Beitrag erläutert. Bei weltweit zunehmender Tumorlast ist trotz Fortschritten in der Systemtherapie von einer steigenden Bedeutung der Verfahren auszugehen.

Abstract

The current guidelines for diagnosis and therapy of hepatocellular carcinoma give an important role to transarterial therapies and are often the treatment of choice in the intermediate stage. Different modalities like radioembolization and different forms of chemoembolization with their specific indications and methods will be explained. With an increasing global tumor burden, it is likely that their importance increases in spite of advances in systemic therapy.

Kernaussagen

• Beim intermediären HCC ist die transarterielle Therapie nach wie vor ein leitliniengerechter Standard.

• Die Kenntnis der unterschiedlichen Therapieverfahren samt Vorteilen und Limitationen stärkt die Rolle des Radiologen in einem multidisziplinären Tumorboard.

• Auch für sonst schwierig behandelbare Patienten bestehen z. B. mit biodegradierbaren Partikeln noch transarterielle Behandlungsoptionen.

• Leitliniengerecht soll das Therapieansprechen nach transarterieller Behandlung nach mRECIST beurteilt werden.

• Die technisch sorgfältige Ausführung und das klinische Verständnis sichern den Behandlungserfolg.

Schlüsselwörter

HCC - hepatozelluläres Karzinom - Chemoembolisation - Radioembolisation - SIRT - TARE - TACE

Keywords

HCC - hepatocellular carcinoma - chemoembolization - radioembolization - SIRT - TARE - TACE

Publication History

Article published online:
06 December 2024

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