Interventional Radiological Technologies in the Treatment of Patients with an Intermediate Stage of HCC (BCLCB)
https://doi.org/10.37174/2587-7593-2018-1-1-60-62
Abstract
Currently, in the treatment of the patients with HCC in the vast majority of cases, interventional radiological (IR) technologies are used. Locoregional technologies can be applied practically at all stages of the treatment of the patients with HCC. The performance of a particular IR intervention depends on the prevalence of the tumor lesion, the patient’s somatic status and the stage of the treatment. The most important are the IR techniques used as a special antitumor treatment, one of which is transarterial chemoembolization (TACE). Modern medical institutions have the main arsenal of therapeutic methods (including locoregional) and the choice of method of the treatment in each specific case largely depends on the technological capabilities of the clinic and the clinical experience of physicians. Despite the fact that locoregional techniques have been performed for quite a long period of time, an optimal algorithm for their application in the treatment of patients with HCC has not yet been developed.
Today, interventional radiological technologies used as locoregional therapy allow to expand the possibilities of potentially radical methods of the treatment (resection, liver transplantation) and to conduct special antitumor treatment in the majority of inoperable patients with HCC.
About the Authors
B. I. DolgushinRussian Federation
Moscow
E. R. Virshke
Russian Federation
Moscow
V. Yu. Kosirev
Russian Federation
Moscow
References
1. Cormier J.N., Thomas K.T., Chari R.S. et al. Management of hepatocellular carcinoma // J. Gastrointest. Sur. 2006. Vol. 10. № 5. P. 761–780.
2. Llovet J.M., Fuster J., Bruix J. The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. // Liver Transplantation. 2004. Vol. 10. Suppl. 1. P. 115–120.
3. Zhou Y., Zhao Y., Li B. et al. Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma // BMC Gastroenterol. 2010. Vol. 10. P. 78–89.
4. Jia-Yan Ni. Meta-analysis of radiofrequency ablation in combination with transarterial chemoembolization for hepatocellular carcinoma // World J. Gastroenterol. 2013. Vol. 19. № 24. P. 3872–388.
5. Peng Z.W., Zhang Y.J., Chen M.S. et al. Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial // J. Clin. Oncol. 2013. Vol. 31. № 4. P. 426–32.
6. Ginsburg M., Zivin S.P, Wroblewski K. et al. Comparison of combination therapies in the management of hepatocellular carcinoma: transarterial chemoembolization with radiofrequency ablation versus microwave ablation // Radiol. J. Vasc. Intervent. 2015. Vol. 26. № 3. P. 330–341.
7. Marelli L., Stigliano R., Triantos C. et al. Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies // Cardiovasc. Intervent. Radiol. 2007. Vol. 30. P. 6–25.
8. Bargellini I., Florio F., Golfieri R. et al. Trends in utilization of transarterial treatments for hepatocellular carcinoma: results of a survey by the Italian Society of Interventional Radiology // Cardiovasc. Intervent. Radiol. 2014. Vol. 37. P. 438–444.
9. Lencioni R., Llovet J.M. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma // Semin. Liver Dis. 2010. Vol. 30. P. 52–60.
10. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma // J. Hepatol. 2012. Vol. 56. P. 908–943.
11. Lo C.M., Ngan H., Tso W.K. et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma // Hepatology. 2002. Vol. 35. P. 1164– 1171.
12. Llovet J.M., Real M.I., Montaña X. et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial // Lancet. 2002. Vol. 359. P. 1734–1739.
13. Terzi E., Golfieri R., Piscaglia F. et al. Response rate and clinical outcome of HCC after first and repeated cTACE performed “on demand” // J. Hepatol. 2012. Vol. 57. P. 1258–1267.
14. Bolondi L., Burroughs A., Dufour J.F. et al. Heterogeneity of patients with intermediate (BCLC B) hepatocellular carcinoma: proposal for a subclassification to facilitate treatment decisions // Semin. Liver Dis. 2012. Vol. 32. P. 348–359.
15. Lammer J., Malagari K., Vogl T. et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study // Cardiovasc. Intervent. Radiol. 2010. Vol. 33. P. 41–52.
16. Xie F., Zang J., Guo X. et al. Comparison of transcatheter arterial chemoembolization and microsphere embolization for treatment of unresectable hepatocellular carcinoma: a metaanalysis // J. Cancer Res. Clin. Oncol. 2012. Vol. 138. P. 455–462.
17. Golfieri R., Giampalma E., Renzulli M. et al. Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma // Brit. J. Cancer 2014. Vol. 111. P. 255–264.
18. Chok K.S., Cheung T.T., Lo R.C. et al. Pilot study of highintensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients wait-listed for liver transplantation // Liver Transpl. 2014. Vol. 20. P. 912–921.
19. Cescon M., Cucchetti A., Ravaioli M., Pinna A.D. Hepatocellular carcinoma locoregional therapies for patients in the waiting list. Impact on transplantability and recurrence rate // J. Hepatol. 2013. Vol. 58. P. 609–618.
Review
For citations:
Dolgushin B.I., Virshke E.R., Kosirev V.Yu. Interventional Radiological Technologies in the Treatment of Patients with an Intermediate Stage of HCC (BCLCB). Journal of oncology: diagnostic radiology and radiotherapy. 2018;1(1):60-62. (In Russ.) https://doi.org/10.37174/2587-7593-2018-1-1-60-62