Semin intervent Radiol 2006; 23(1): 033-038
DOI: 10.1055/s-2006-939839
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Combining Local and Regional Therapeutic Modalities to Treat Hepatic Malignancies

William S. Rilling1 , Eric J. Hohenwalter1
  • 1Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
Further Information

Publication History

Publication Date:
04 April 2006 (online)

ABSTRACT

Hepatocellular carcinoma and metastatic colon cancer have proven to be challenging problems in oncology today. Currently multiple treatment options are available for treating patients with these diseases, and for this reason, a multimodality and multidisciplinary approach is needed to optimize the effectiveness of treatment. Local ablation techniques along with intra-arterial therapy may be complementary and therefore increase survival in patients being treated for hepatocellular carcinoma and metastatic colon cancer. With proper patient selection, further improvement in treatment outcomes can be achieved when these techniques are combined with surgical resection and multidrug systemic chemotherapy. Therefore, it is imperative that interventional radiologists work closely with our colleagues in other medical and surgical specialties to provide our patients with the best possible treatment options.

REFERENCES

  • 1 Kitamoto M, Imagawa M, Hiroyasu Y et al.. Radiofrequency ablation in the treatment of small hepatocellular carcinomas: comparison of the radiofrequency effect with and without chemoembolization.  AJR Am J Roentgenol. 2003;  181 997-1003
  • 2 Maluccio M, Covey A, Gandhi R et al.. Comparison of survival rates after bland arterial embolization and ablation versus surgical resection for treating solitary hepatocellular carcinoma up to 7 cm.  J Vasc Interv Radiol. 2005;  16 955-961
  • 3 Koda M, Murawaki Y, Mitsuda A et al.. Combination therapy with transcatheter arterial chemoembolization and percutaneous ethanol injection compared with percutaneous ethanol injection alone for patients with small hepatocellular carcinoma: a randomized control study.  Cancer. 2001;  92 1516-1524
  • 4 Kamada K, Kitamoto M, Aikata H et al.. Combination of transcatheter arterial chemoembolization using cisplatin-lipiodol suspension and percutaneous ethanol injection for treatment of advanced small hepatocellular carcinoma.  Am J Surg. 2002;  184 284-290
  • 5 Yamakado K, Nakatsuka A, Ohmori S et al.. Radiofrequency ablation combined with chemoembolization in hepatocellular carcinoma: treatment response based on tumor size and morphology.  J Vasc Interv Radiol. 2002;  13 1225-1232
  • 6 Yamakado K, Nakatsuka A, Akeboshi M et al.. Combination therapy with radiofrequency ablation and transcatheter chemoembolization for the treatment of hepatocellular carcinoma: short-term recurrences and survival.  Oncol Rep. 2004;  11 105-109
  • 7 Goldberg S N, Kamel I R, Kruskal J B et al.. Radiofrequency ablation of liver tumor: increased coagulation with adjuvant liposomal doxorubicin therapy.  AJR Am J Roentgenol. 2002;  179 93-101
  • 8 Llovet J M, Fuster J, Bruix J. Intention to treat analysis of surgical treatment for early hepatocellular carcinoma: resection vs. transplantation.  Hepatology. 1999;  30 1434-1440
  • 9 Harnois D M, Steers J, Andrews J C et al.. Preoperative hepatic artery chemoembolization followed by orthotopic liver transplantation for hepatocellular carcinoma.  Liver Transpl Surg. 1999;  5 192-199
  • 10 Lau W, Ho S K, Yu S C et al.. Salvage surgery following downstaging of unresectable hepatocellular carcinoma.  Ann Surg. 2004;  240 299-305
  • 11 Liu M, Uaje M, Al-Ghazi M S et al.. Use of Yttrium-90 TheraSphere for the treatment of unresectable hepatocellular carcinoma.  Am Surg. 2004;  70 947-953
  • 12 Geschwind J F, Salem R, Carr B I et al.. Yttrium-90 microspheres for the treatment of hepatocellular carcinoma.  Gastroenterology. 2004;  127(suppl 1) S194-S205
  • 13 Mathurin P, Raynard B, Dharancy S et al.. Meta-analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma.  Aliment Pharmacol Ther. 2003;  17 1247-1261
  • 14 Chan E SY, Chow P KH, Ta B C et al.. Neoadjuvant and adjuvant therapy for operable hepatocellular carcinoma.  Cochrane Database Syst Rev. 2004;  (4)
  • 15 Mok K T, Wang B W, Lo G H et al.. Multimodality management of hepatocellular carcinoma larger than 10 cm.  J Am Coll Surg. 2003;  197 730-738
  • 16 Dohmen K, Shirahama M, Shigematsu H et al.. Transcatheter arterial chemoembolization therapy combined with percutaneous ethanol injection for unresectable large hepatocellular carcinoma: an evaluation of the local therapeutic effect and survival rate.  Hepatogastroenterology. 2001;  48 1409-1415
  • 17 Guo W J, Yu E K. The long-term efficacy of combined chemoembolization and local irradiation in the treatment of patients with large hepatocellular carcinoma.  Hepatogastroenterology. 2003;  50 500-503
  • 18 Li B, Wang L, Li C et al.. Study of local three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for patients with stage III hepatocellular carcinoma.  Am J Clin Oncol. 2003;  26 e92-e99
  • 19 Gray B, Van Hazel G, Hope M et al.. Randomized trial of SIR-Spheres plus chemotherapy vs. chemotherapy alone for treating patients with liver metastases from primary large bowel cancer.  Ann Oncol. 2001;  12 1711-1720
  • 20 Taylor W E, Donohue J H, Gunderson L L et al.. The Mayo Clinic experience with multimodality treatment of locally advanced or recurrent colon cancer.  Ann Surg Oncol. 2002;  9 177-185

Eric J HohenwalterM.D. 

Assistant Professor of Radiology, Vascular and Interventional Radiology

Department of Radiology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226

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