open access

Vol 22, No 2 (2017)
Special Issue Papers
Published online: 2017-03-01
Submitted: 2016-02-07
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Other non-surgical treatments for liver cancer

Paul Revel-Mouroz, Philippe Otal, Marion Jaffro, Antoine Petermann, Olivier Meyrignac, Pierre Rabinel, Fatima-Zohra Mokrane
DOI: 10.1016/j.rpor.2017.02.007
·
Rep Pract Oncol Radiother 2017;22(2):181-192.

open access

Vol 22, No 2 (2017)
Special Issue Papers
Published online: 2017-03-01
Submitted: 2016-02-07

Abstract

Interventional radiology plays a major role in the modern management of liver cancers, in primary hepatic malignancies or metastases and in palliative or curative situations. Radiological treatments are divided in two categories based on their approach: endovascular treatment and direct transcapsular access.

Endovascular treatments include mainly three applications: transarterial chemoembolization (TACE), transarterial radioembolization (TARE) and portal vein embolization (PVE). TACE and TARE share an endovascular arterial approach, consisting of a selective catheterization of the hepatic artery or its branches. Subsequently, either a chemotherapy (TACE) or radioembolic (TARE) agent is injected in the target vessel to act on the tumor. PVE raises the volume of the future liver remnant in extended hepatectomy by embolizing a portal vein territory which results in hepatic regeneration.

Direct transcapsular access treatments involve mainly three techniques: radiofrequency thermal ablation (RFA), microwave thermal ablation (MWA) and percutaneous ethanol injection (PEI). RFA and MWA procedures are almost identical, their clinical applications are similar. A probe is deployed directly into the tumor to generate heat and coagulation necrosis. PEI has known implications based on the chemical toxicity of intra-tumoral injection with highly concentrated alcohol by a thin needle.

Abstract

Interventional radiology plays a major role in the modern management of liver cancers, in primary hepatic malignancies or metastases and in palliative or curative situations. Radiological treatments are divided in two categories based on their approach: endovascular treatment and direct transcapsular access.

Endovascular treatments include mainly three applications: transarterial chemoembolization (TACE), transarterial radioembolization (TARE) and portal vein embolization (PVE). TACE and TARE share an endovascular arterial approach, consisting of a selective catheterization of the hepatic artery or its branches. Subsequently, either a chemotherapy (TACE) or radioembolic (TARE) agent is injected in the target vessel to act on the tumor. PVE raises the volume of the future liver remnant in extended hepatectomy by embolizing a portal vein territory which results in hepatic regeneration.

Direct transcapsular access treatments involve mainly three techniques: radiofrequency thermal ablation (RFA), microwave thermal ablation (MWA) and percutaneous ethanol injection (PEI). RFA and MWA procedures are almost identical, their clinical applications are similar. A probe is deployed directly into the tumor to generate heat and coagulation necrosis. PEI has known implications based on the chemical toxicity of intra-tumoral injection with highly concentrated alcohol by a thin needle.

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Keywords

Transarterial chemoembolization; Transarterial radioembolization; Portal vein embolization; Radiofrequency thermal ablation; Microwave thermal ablation; Percutaneous ethanol injection

About this article
Title

Other non-surgical treatments for liver cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 22, No 2 (2017)

Pages

181-192

Published online

2017-03-01

DOI

10.1016/j.rpor.2017.02.007

Bibliographic record

Rep Pract Oncol Radiother 2017;22(2):181-192.

Keywords

Transarterial chemoembolization
Transarterial radioembolization
Portal vein embolization
Radiofrequency thermal ablation
Microwave thermal ablation
Percutaneous ethanol injection

Authors

Paul Revel-Mouroz
Philippe Otal
Marion Jaffro
Antoine Petermann
Olivier Meyrignac
Pierre Rabinel
Fatima-Zohra Mokrane

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