Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Medical Oncology
Published in: Medical Oncology 4/2017

01-04-2017 | Original Paper

New concepts in embolotherapy of HCC

Authors: F. Pesapane, N. Nezami, F. Patella, J. F. Geschwind

Published in: Medical Oncology | Issue 4/2017

Login to get access

Abstract

Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related deaths worldwide with rapidly growing incidence rates in the USA and Europe. Despite improving surveillance programs, most patients are diagnosed at intermediate to advanced stages and are no longer amenable to curative therapies, such as ablation, surgical resection and liver transplantation. For such patients, catheter-based image-guided embolotherapies such as transarterial chemoembolization (TACE) represent the standard of care and mainstay therapy, as recommended and endorsed by a variety of national guidelines and staging systems. The main benefit of these therapies is explained by the preferentially arterial blood supply of liver tumors, which allows to deliver the anticancer therapy directly to the tumor-feeding artery while sparing the healthy hepatic tissue mainly supplied by the portal vein. The tool box of an interventional oncologist contains several different variants of transarterial treatment modalities. Ever since the first TACE more than 30 years ago, these techniques have been progressively refined, both with respect to drug delivery materials and with respect to angiographic micro-catheter and image-guidance technology, thus substantially improving therapeutic outcomes of HCC. This review will summarize the fundamental principles, technical and clinical data on the application of different embolotherapies, such as bland transarterial embolization, Lipiodol-based conventional transarterial chemoembolization as well as TACE with drug-eluting beads (DEB-TACE). Clinical data on 90Yttrium radioembolization as an emerging alternative, mostly applied for niche indications such as HCC with portal vein invasion, will be discussed. Furthermore, we will summarize the principle of HCC staging, patient allocation and response assessment in the setting of HCC embolotherapy. In addition, we will evaluate the role of cone-beam computed tomography as a novel intra-procedural image-guidance technology. Finally, this review will touch on new technical developments such as radiopaque, imageable DEBs and the rationale and role of combined systemic and locoregional therapies, mostly in combination with Sorafenib.
Literature
1.
2.
Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.PubMedCrossRef
3.
Han KH, Kudo M, Ye SL, et al. Asian consensus workshop report: expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia. Oncology. 2011;81(Suppl 1):158–64.PubMedCrossRef
4.
Schmidt S, Follmann M, Malek N, Manns MP, Greten TF. Critical appraisal of clinical practice guidelines for diagnosis and treatment of hepatocellular carcinoma. J Gastroenterol Hepatol. 2011;26(12):1779–86.PubMedCrossRef
5.
6.
Lan T, Chang L, Rahmathullah MN, Wu L, Yuan YF. Comparative efficacy of interventional therapies for early-stage hepatocellular carcinoma: a PRISMA-compliant systematic review and network meta-analysis. Medicine. 2016;95(15):e3185.PubMedPubMedCentralCrossRef
7.
8.
9.
Naugler WE, Alsina AE, Frenette CT, Rossaro L, Sellers MT. Building the multidisciplinary team for management of patients with hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2015;13(5):827–35.PubMedCrossRef
10.
European Association For The Study Of The L, European Organisation For R, Treatment Of C. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908–43.CrossRef
11.
Llovet JM, Real MI, Montana X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359(9319):1734–9.PubMedCrossRef
12.
Lo CM, Ngan H, Tso WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002;35(5):1164–71.PubMedCrossRef
13.
Raoul JL, Sangro B, Forner A, et al. Evolving strategies for the management of intermediate-stage hepatocellular carcinoma: available evidence and expert opinion on the use of transarterial chemoembolization. Cancer Treat Rev. 2011;37(3):212–20.PubMedCrossRef
14.
Kim KM, Kim JH, Park IS, et al. Reappraisal of repeated transarterial chemoembolization in the treatment of hepatocellular carcinoma with portal vein invasion. J Gastroenterol Hepatol. 2009;24(5):806–14.PubMedCrossRef
15.
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(2):413–20.PubMedCrossRef
16.
Sangro B, Inarrairaegui M, Bilbao JI. Radioembolization for hepatocellular carcinoma. J Hepatol. 2012;56(2):464–73.PubMedCrossRef
17.
Tacher V, Lin M, Duran R, et al. Comparison of existing response criteria in patients with hepatocellular carcinoma treated with transarterial chemoembolization using a 3D quantitative approach. Radiology. 2016;278(1):275–84.PubMedCrossRef
18.
Sieghart W, Hucke F, Pinter M, et al. The ART of decision making: retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma. Hepatology. 2013;57(6):2261–73.PubMedCrossRef
19.
Gonzalez-Guindalini FD, Botelho MP, Harmath CB, et al. Assessment of liver tumor response to therapy: role of quantitative imaging. Radiographics. 2013;33(6):1781–800.PubMedCrossRef
20.
Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16.CrossRef
21.
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.PubMedCrossRef
22.
Forner A, Ayuso C, Varela M, et al. Evaluation of tumor response after locoregional therapies in hepatocellular carcinoma: are response evaluation criteria in solid tumors reliable? Cancer. 2009;115(3):616–23.PubMedCrossRef
23.
Lencioni R. New data supporting modified RECIST (mRECIST) for hepatocellular carcinoma. Clin Cancer Res. 2013;19(6):1312–4.PubMedCrossRef
24.
Shim JH, Lee HC, Won HJ, et al. Maximum number of target lesions required to measure responses to transarterial chemoembolization using the enhancement criteria in patients with intrahepatic hepatocellular carcinoma. J Hepatol. 2012;56(2):406–11.PubMedCrossRef
25.
Gillmore R, Stuart S, Kirkwood A, et al. EASL and mRECIST responses are independent prognostic factors for survival in hepatocellular cancer patients treated with transarterial embolization. J Hepatol. 2011;55(6):1309–16.PubMedCrossRef
26.
Prasad SR, Jhaveri KS, Saini S, et al. CT tumor measurement for therapeutic response assessment: comparison of unidimensional, bidimensional, and volumetric techniques initial observations. Radiology. 2002;225(2):416–9.PubMedCrossRef
27.
Suzuki C, Torkzad MR, Jacobsson H, et al. Interobserver and intraobserver variability in the response evaluation of cancer therapy according to RECIST and WHO-criteria. Acta Oncol. 2010;49(4):509–14.PubMedCrossRef
28.
Zhao B, Tan Y, Bell DJ, et al. Exploring intra- and inter-reader variability in uni-dimensional, bi-dimensional, and volumetric measurements of solid tumors on CT scans reconstructed at different slice intervals. Eur J Radiol. 2013;82(6):959–68.PubMedCrossRef
29.
Bonekamp S, Jolepalem P, Lazo M, et al. Hepatocellular carcinoma: response to TACE assessed with semiautomated volumetric and functional analysis of diffusion-weighted and contrast-enhanced MR imaging data. Radiology. 2011;260(3):752–61.PubMedCrossRef
30.
Mantatzis M, Kakolyris S, Amarantidis K, Karayiannakis A, Prassopoulos P. Treatment response classification of liver metastatic disease evaluated on imaging. Are RECIST unidimensional measurements accurate? Eur Radiol. 2009;19(7):1809–16.PubMedCrossRef
31.
Sohaib SA, Turner B, Hanson JA, et al. CT assessment of tumour response to treatment: comparison of linear, cross-sectional and volumetric measures of tumour size. Br J Radiol. 2000;73(875):1178–84.PubMedCrossRef
32.
Bonekamp S, Li Z, Geschwind JF, et al. Unresectable hepatocellular carcinoma: MR imaging after intraarterial therapy. Part I. Identification and validation of volumetric functional response criteria. Radiology. 2013;268(2):420–30.PubMedPubMedCentralCrossRef
33.
Chapiro J, Lin M, Duran R, Schernthaner RE, Geschwind JF. Assessing tumor response after loco-regional liver cancer therapies: the role of 3D MRI. Expert Rev Anticancer Ther. 2015;15(2):199–205.PubMedCrossRef
34.
Lin M, Pellerin O, Bhagat N, et al. Quantitative and volumetric European Association for the Study of the Liver and Response Evaluation Criteria in Solid Tumors measurements: feasibility of a semiautomated software method to assess tumor response after transcatheter arterial chemoembolization. J Vasc Interv Radiol. 2012;23(12):1629–37.PubMedPubMedCentralCrossRef
35.
Konno T, Maeda H, Iwai K, et al. Effect of arterial administration of high-molecular-weight anticancer agent SMANCS with lipid lymphographic agent on hepatoma: a preliminary report. Eur J Cancer Clin Oncol. 1983;19(8):1053–65.PubMedCrossRef
36.
Woo HY, Heo J. Transarterial chemoembolization using drug eluting beads for the treatment of hepatocellular carcinoma: now and future. Clin Mol Hepatol. 2015;21(4):344–8.PubMedPubMedCentralCrossRef
37.
Duran R, Chapiro J, Schernthaner RE, Geschwind JF. Systematic review of catheter-based intra-arterial therapies in hepatocellular carcinoma: state of the art and future directions. Br J Radiol. 1052;2015(88):20140564.
38.
Brown DB, Cardella JF, Sacks D, et al. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol. 2006;17(2 Pt 1):225–32.PubMedCrossRef
39.
Lewis AL, Holden RR. DC Bead embolic drug-eluting bead: clinical application in the locoregional treatment of tumours. Expert Opin Drug Deliv. 2011;8(2):153–69.PubMedCrossRef
40.
Prompers L, Bucerius J, Brans B, et al. Selective internal radiation therapy (SIRT) in primary or secondary liver cancer. Methods. 2011;55(3):253–7.PubMedCrossRef
41.
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;30(1):6–25.PubMedCrossRef
42.
de Baere T, Arai Y, Lencioni R, et al. Treatment of liver tumors with lipiodol TACE: technical recommendations from experts opinion. Cardiovasc Intervent Radiol. 2016;39(3):334–43.PubMedCrossRef
43.
Lencioni R, de Baere T, Soulen MC, Rilling WS, Geschwind JF. Lipiodol transarterial chemoembolization for hepatocellular carcinoma: a systematic review of efficacy and safety data. Hepatology. 2016;64(1):106–16.PubMedCrossRef
44.
Madden MV, Krige JE, Bailey S, et al. Randomised trial of targeted chemotherapy with lipiodol and 5-epidoxorubicin compared with symptomatic treatment for hepatoma. Gut. 1993;34(11):1598–600.PubMedPubMedCentralCrossRef
45.
Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire. A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med. 1995;332(19):1256–61.CrossRef
46.
Pelletier G, Ducreux M, Gay F, et al. Treatment of unresectable hepatocellular carcinoma with lipiodol chemoembolization: a multicenter randomized trial. Groupe CHC J Hepatol. 1998;29(1):129–34.PubMedCrossRef
47.
Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37(2):429–42.PubMedCrossRef
48.
Bruix J, Sherman M. Practice guidelines committee AAftSoLD. Management of hepatocellular carcinoma. Hepatology. 2005;42(5):1208–36.PubMedCrossRef
49.
Miyayama S, Matsui O, Yamashiro M, et al. Ultraselective transcatheter arterial chemoembolization with a 2-f tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein with iodized oil. J Vasc Interv Radiol. 2007;18(3):365–76.PubMedCrossRef
50.
Miyayama S, Yamashiro M, Ikuno M, Okumura K, Yoshida M. Ultraselective transcatheter arterial chemoembolization for small hepatocellular carcinoma guided by automated tumor-feeders detection software: technical success and short-term tumor response. Abdom Imaging. 2014;39(3):645–56.PubMedCrossRef
51.
Bruix J, Sala M, Llovet JM. Chemoembolization for hepatocellular carcinoma. Gastroenterology. 2004;127(5 Suppl 1):S179–88.PubMedCrossRef
52.
Makuuchi M, Kokudo N, Arii S, et al. Development of evidence-based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan. Hepatol Res. 2008;38(1):37–51.PubMedCrossRef
53.
Takayasu K. Transarterial chemoembolization for hepatocellular carcinoma over three decades: current progress and perspective. Jpn J Clin Oncol. 2012;42(4):247–55.PubMedCrossRef
54.
Cheng AL, Amarapurkar D, Chao Y, et al. Re-evaluating transarterial chemoembolization for the treatment of hepatocellular carcinoma: consensus recommendations and review by an International Expert Panel. Liver Int. 2014;34(2):174–83.PubMedCrossRef
55.
Chung GE, Lee JH, Kim HY, et al. Transarterial chemoembolization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival. Radiology. 2011;258(2):627–34.PubMedCrossRef
56.
Zhao Y, Duran R, Chapiro J, et al. Transarterial chemoembolization for the treatment of advanced-stage hepatocellular carcinoma. J Gastrointest Surg. 2016;20(12):2002–9.PubMedCrossRef
57.
Gorodetski B, Chapiro J, Schernthaner R, et al. Advanced-stage hepatocellular carcinoma with portal vein thrombosis: conventional versus drug-eluting beads transcatheter arterial chemoembolization. Eur Radiol. 2017;27(2):526–35.PubMedCrossRef
58.
Reyes DK, Vossen JA, Kamel IR, et al. Single-center phase II trial of transarterial chemoembolization with drug-eluting beads for patients with unresectable hepatocellular carcinoma: initial experience in the United States. Cancer J. 2009;15(6):526–32.PubMedPubMedCentralCrossRef
59.
Jordan O, Denys A, De Baere T, Boulens N, Doelker E. Comparative study of chemoembolization loadable beads: in vitro drug release and physical properties of DC bead and hepasphere loaded with doxorubicin and irinotecan. J Vasc Interv Radiol. 2010;21(7):1084–90.PubMedCrossRef
60.
Varela M, Real MI, Burrel M, et al. Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol. 2007;46(3):474–81.PubMedCrossRef
61.
Poon RT, Tso WK, Pang RW, et al. A phase I/II trial of chemoembolization for hepatocellular carcinoma using a novel intra-arterial drug-eluting bead. Clin Gastroenterol Hepatol. 2007;5(9):1100–8.PubMedCrossRef
62.
Malagari K, Pomoni M, Moschouris H, et al. Chemoembolization with doxorubicin-eluting beads for unresectable hepatocellular carcinoma: five-year survival analysis. Cardiovasc Intervent Radiol. 2012;35(5):1119–28.PubMedCrossRef
63.
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(6):1330–5.PubMedCrossRef
64.
Spreafico C, Cascella T, Facciorusso A, et al. Transarterial chemoembolization for hepatocellular carcinoma with a new generation of beads: clinical-radiological outcomes and safety profile. Cardiovasc Intervent Radiol. 2015;38(1):129–34.PubMedCrossRef
65.
Deipolyi AR, Oklu R, Al-Ansari S, et al. Safety and efficacy of 70-150 mum and 100-300 mum drug-eluting bead transarterial chemoembolization for hepatocellular carcinoma. J Vasc Interv Radiol. 2015;26(4):516–22.PubMedCrossRef
66.
Duran R, Sharma K, Dreher MR, et al. A novel inherently radiopaque bead for transarterial embolization to treat liver cancer—a pre-clinical study. Theranostics. 2016;6(1):28–39.PubMedPubMedCentralCrossRef
67.
Levy EB, Krishnasamy VP, Lewis AL, et al. First human experience with directly image-able iodinated embolization microbeads. Cardiovasc Intervent Radiol. 2016;39(8):1177–86.PubMedCrossRef
68.
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;33(1):41–52.PubMedCrossRef
69.
Song MJ, Chun HJ, Song DS, et al. Comparative study between doxorubicin-eluting beads and conventional transarterial chemoembolization for treatment of hepatocellular carcinoma. J Hepatol. 2012;57(6):1244–50.PubMedCrossRef
70.
Golfieri R, Giampalma E, Renzulli M, et al. Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma. Br J Cancer. 2014;111(2):255–64.PubMedPubMedCentralCrossRef
71.
Mu L, Chapiro J, Stringam J, Geschwind JF. Interventional oncology in hepatocellular carcinoma: progress through innovation. Cancer J. 2016;22(6):365–72.PubMedCrossRef
72.
Bruix J, Llovet JM, Castells A, et al. Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma: results of a randomized, controlled trial in a single institution. Hepatology. 1998;27(6):1578–83.PubMedCrossRef
73.
Maluccio MA, Covey AM, Porat LB, et al. Transcatheter arterial embolization with only particles for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2008;19(6):862–9.PubMedCrossRef
74.
Malagari K, Pomoni M, Kelekis A, et al. Prospective randomized comparison of chemoembolization with doxorubicin-eluting beads and bland embolization with BeadBlock for hepatocellular carcinoma. Cardiovasc Intervent Radiol. 2010;33(3):541–51.PubMedCrossRef
75.
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(4):422–31.PubMedCrossRef
76.
Woodall CE, Scoggins CR, Ellis SF, et al. Is selective internal radioembolization safe and effective for patients with inoperable hepatocellular carcinoma and venous thrombosis? J Am Coll Surg. 2009;208(3):375–82.PubMedCrossRef
77.
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):1632–8.PubMedCrossRef
78.
Riaz A, Lewandowski RJ, Kulik L, et al. Radiologic-pathologic correlation of hepatocellular carcinoma treated with chemoembolization. Cardiovasc Intervent Radiol. 2010;33(6):1143–52.PubMedCrossRef
79.
Kulik L, Vouche M, Koppe S, et al. Prospective randomized pilot study of Y90 ± sorafenib as bridge to transplantation in hepatocellular carcinoma. J Hepatol. 2014;61(2):309–17.PubMedCrossRef
80.
Salem R, Gordon AC, Mouli S, et al. Y90 radioembolization significantly prolongs time to progression compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2016;151(6):1155–1163, e1152.
81.
82.
Fidelman N, Kerlan RK Jr. Transarterial chemoembolization and (90)Y radioembolization for hepatocellular carcinoma: review of current applications beyond intermediate-stage disease. AJR Am J Roentgenol. 2015;205(4):742–52.PubMedCrossRef
83.
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(1):71–81.PubMedCrossRef
84.
Hilgard P, Hamami M, Fouly AE, et al. Radioembolization with yttrium-90 glass microspheres in hepatocellular carcinoma: European experience on safety and long-term survival. Hepatology. 2010;52(5):1741–9.PubMedCrossRef
85.
Kim YH, Kim DY. Yttrium-90 radioembolization for hepatocellular carcinoma: what we know and what we need to know. Oncology. 2013;84(Suppl 1):34–9.PubMedCrossRef
86.
Mazzaferro V, Sposito C, Bhoori S, et al. Yttrium-90 radioembolization for intermediate-advanced hepatocellular carcinoma: a phase 2 study. Hepatology. 2013;57(5):1826–37.PubMedCrossRef
87.
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(5):1029–36.PubMedPubMedCentralCrossRef
88.
Kwan SW, Fidelman N, Ma E, Kerlan RK Jr, Yao FY. Imaging predictors of the response to transarterial chemoembolization in patients with hepatocellular carcinoma: a radiological-pathological correlation. Liver Transpl. 2012;18(6):727–36.PubMedPubMedCentralCrossRef
89.
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(8):1920–8.PubMedCrossRef
90.
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(1):192–201.PubMedCrossRef
91.
Stampfl U, Bermejo JL, Sommer CM, et al. Efficacy and nontarget effects of transarterial chemoembolization in bridging of hepatocellular carcinoma patients to liver transplantation: a histopathologic study. J Vasc Interv Radiol. 2014;25(7):1018–1026, e1014.
92.
Greene FL, Sobin LH. The staging of cancer: a retrospective and prospective appraisal. CA Cancer J Clin. 2008;58(3):180–90.PubMedCrossRef
93.
Leung TW, Tang AM, Zee B, et al. Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients. Cancer. 2002;94(6):1760–9.PubMedCrossRef
94.
Llovet JM, Fuster J, Bruix J, Barcelona-Clinic Liver Cancer G. The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transpl. 2004;10(2 Suppl 1):S115–20.PubMedCrossRef
95.
Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–90.PubMedCrossRef
96.
Grieco A, Pompili M, Caminiti G, et al. Prognostic factors for survival in patients with early-intermediate hepatocellular carcinoma undergoing non-surgical therapy: comparison of Okuda, CLIP, and BCLC staging systems in a single Italian centre. Gut. 2005;54(3):411–8.PubMedPubMedCentralCrossRef
97.
Cillo U, Vitale A, Grigoletto F, et al. Prospective validation of the Barcelona Clinic Liver Cancer staging system. J Hepatol. 2006;44(4):723–31.PubMedCrossRef
98.
Marrero JA, Fontana RJ, Barrat A, et al. Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort. Hepatology. 2005;41(4):707–16.PubMedCrossRef
99.
Chapiro J, Geschwind JF. Hepatocellular carcinoma: have we finally found the ultimate staging system for HCC? Nat Rev Gastroenterol Hepatol. 2014;11(6):334–6.PubMedCrossRef
100.
Sohn JH, Duran R, Zhao Y, et al. Validation of the Hong Kong liver cancer staging system in determining prognosis of the North American patients following intra-arterial therapy. Clin Gastroenterol Hepatol. 2016. doi:10.​1016/​j.​cgh.​2016.​10.​036.
101.
Bapst B, Lagadec M, Breguet R, Vilgrain V, Ronot M. Cone beam computed tomography (CBCT) in the field of interventional oncology of the liver. Cardiovasc Intervent Radiol. 2016;39(1):8–20.PubMedCrossRef
102.
Tacher V, Radaelli A, Lin M, Geschwind JF. How I do it: cone-beam CT during transarterial chemoembolization for liver cancer. Radiology. 2015;274(2):320–34.PubMedPubMedCentralCrossRef
103.
Wang Z, Chen R, Duran R, et al. Intraprocedural 3D quantification of lipiodol deposition on cone-beam CT predicts tumor response after transarterial chemoembolization in patients with hepatocellular carcinoma. Cardiovasc Intervent Radiol. 2015;38(6):1548–56.PubMedPubMedCentralCrossRef
104.
Lee IJ, Chung JW, Yin YH, et al. Cone-beam computed tomography (CBCT) hepatic arteriography in chemoembolization for hepatocellular carcinoma: performance depicting tumors and tumor feeders. Cardiovasc Intervent Radiol. 2015;38(5):1218–30.PubMedCrossRef
105.
Carrafiello G, Ierardi AM, Duka E, et al. Usefulness of cone-beam computed tomography and automatic vessel detection software in emergency transarterial embolization. Cardiovasc Intervent Radiol. 2016;39(4):530–7.PubMedCrossRef
106.
Chiaradia M, Radaelli A, Campeggi A, et al. Automatic three-dimensional detection of prostatic arteries using cone-beam CT during prostatic arterial embolization. J Vasc Interv Radiol. 2015;26(3):413–7.PubMedCrossRef
107.
Loffroy R, Lin M, Yenokyan G, et al. Intraprocedural C-arm dual-phase cone-beam CT: can it be used to predict short-term response to TACE with drug-eluting beads in patients with hepatocellular carcinoma? Radiology. 2013;266(2):636–48.PubMedPubMedCentralCrossRef
108.
Loffroy R, Lin M, Rao P, et al. Comparing the detectability of hepatocellular carcinoma by C-arm dual-phase cone-beam computed tomography during hepatic arteriography with conventional contrast-enhanced magnetic resonance imaging. Cardiovasc Intervent Radiol. 2012;35(1):97–104.PubMedCrossRef
109.
Paul J, Mbalisike EC, Vogl TJ. Ultrafast cone-beam computed tomography imaging and postprocessing data during image-guided therapeutic practice. Eur Radiol. 2014;24(11):2866–75.PubMedCrossRef
110.
Kothary N, Abdelmaksoud MH, Tognolini A, et al. Imaging guidance with C-arm CT: prospective evaluation of its impact on patient radiation exposure during transhepatic arterial chemoembolization. J Vasc Interv Radiol. 2011;22(11):1535–43.PubMedCrossRef
111.
Schernthaner RE, Duran R, Chapiro J, et al. A new angiographic imaging platform reduces radiation exposure for patients with liver cancer treated with transarterial chemoembolization. Eur Radiol. 2015;25(11):3255–62.PubMedPubMedCentralCrossRef
112.
Abdel-Rehim M, Ronot M, Sibert A, Vilgrain V. Assessment of liver ablation using cone beam computed tomography. World J Gastroenterol. 2015;21(2):517–24.PubMedPubMedCentralCrossRef
113.
Cazzato RL, Buy X, Alberti N, et al. Flat-panel cone-beam CT-guided radiofrequency ablation of very small (≤ 1.5 cm) liver tumors: technical note on a preliminary experience. Cardiovasc Intervent Radiol. 2015;38(1):206–12.PubMedCrossRef
114.
Morimoto M, Numata K, Kondo M, et al. C-arm cone beam CT for hepatic tumor ablation under real-time 3D imaging. AJR Am J Roentgenol. 2010;194(5):W452–4.PubMedCrossRef
115.
Liang PC, Lai HS, Shih TT, Wu CH, Huang KW. The pilot experience upon surgical ablation of large liver tumor by microwave system with tissue permittivity feedback control mechanism. BMC Surg. 2014;14:82.PubMedPubMedCentralCrossRef
116.
117.
Niessen C, Beyer LP, Pregler B, et al. Percutaneous ablation of hepatic tumors using irreversible electroporation: a prospective safety and midterm efficacy study in 34 patients. J Vasc Interv Radiol. 2016;27(4):480–6.PubMedCrossRef
118.
Tawada A, Chiba T, Ooka Y, et al. Efficacy of transarterial chemoembolization targeting portal vein tumor thrombus in patients with hepatocellular carcinoma. Anticancer Res. 2014;34(8):4231–7.PubMed
119.
120.
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(1):32–40.PubMedCrossRef
121.
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(1):73–80.PubMedCrossRef
122.
Kudo M, Han G, Finn RS, et al. Brivanib as adjuvant therapy to transarterial chemoembolization in patients with hepatocellular carcinoma: a randomized phase III trial. Hepatology. 2014;60(5):1697–707.PubMedCrossRef
123.
Choi GH, Shim JH, Kim MJ, et al. Sorafenib alone versus sorafenib combined with transarterial chemoembolization for advanced-stage hepatocellular carcinoma: results of propensity score analyses. Radiology. 2013;269(2):603–11.PubMedCrossRef
124.
Chao Y, Chung YH, Han G, et al. The combination of transcatheter arterial chemoembolization and sorafenib is well tolerated and effective in Asian patients with hepatocellular carcinoma: final results of the START trial. Int J Cancer. 2015;136(6):1458–67.PubMedCrossRef
125.
Cosgrove DP, Reyes DK, Pawlik TM, et al. Open-label single-arm phase II trial of sorafenib therapy with drug-eluting bead transarterial chemoembolization in patients with unresectable hepatocellular carcinoma: clinical results. Radiology. 2015;277(2):594–603.PubMedCrossRef
126.
Geschwind JF, Kudo M, Marrero JA, et al. TACE treatment in patients with sorafenib-treated unresectable hepatocellular carcinoma in clinical practice: final analysis of GIDEON. Radiology. 2016;279(2):630–40.PubMedCrossRef
127.
Pawlik TM, Reyes DK, Cosgrove D, et al. Phase II trial of sorafenib combined with concurrent transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma. J Clin Oncol. 2011;29(30):3960–7.PubMedPubMedCentralCrossRef
128.
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(5):1090–8.PubMedCrossRef
129.
Salem R, Gilbertsen M, Butt Z, et al. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin Gastroenterol Hepatol. 2013;11(10):1358–1365, e1351.
130.
Chow PK, Poon DY, Khin MW, et al. Multicenter phase II study of sequential radioembolization-sorafenib therapy for inoperable hepatocellular carcinoma. PLoS ONE. 2014;9(3):e90909.PubMedPubMedCentralCrossRef
131.
Ricke J, Bulla K, Kolligs F, et al. Safety and toxicity of radioembolization plus Sorafenib in advanced hepatocellular carcinoma: analysis of the European multicentre trial SORAMIC. Liver Int. 2015;35(2):620–6.PubMedCrossRef
132.
Vilgrain V, Abdel-Rehim M, Sibert A, et al. Radioembolisation with yttrium90 microspheres versus sorafenib for treatment of advanced hepatocellular carcinoma (SARAH): study protocol for a randomised controlled trial. Trials. 2014;15:474.PubMedPubMedCentralCrossRef
133.
Cho YY, Lee M, Kim HC, et al. Radioembolization is a safe and effective treatment for hepatocellular carcinoma with portal vein thrombosis: a propensity score analysis. PLoS ONE. 2016;11(5):e0154986.PubMedPubMedCentralCrossRef
134.
Dreher MR, Sharma KV, Woods DL, et al. Radiopaque drug-eluting beads for transcatheter embolotherapy: experimental study of drug penetration and coverage in swine. J Vasc Interv Radiol. 2012;23(2):257–264, e254.
135.
Miyayama S, Yamashiro M, Hashimoto M, et al. Identification of small hepatocellular carcinoma and tumor-feeding branches with cone-beam CT guidance technology during transcatheter arterial chemoembolization. J Vasc Interv Radiol. 2013;24(4):501–8.PubMedCrossRef
Metadata
Title
New concepts in embolotherapy of HCC
Authors
F. Pesapane
N. Nezami
F. Patella
J. F. Geschwind
Publication date
01-04-2017
Publisher
Springer US
Published in
Medical Oncology / Issue 4/2017
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-017-0917-2

Other articles of this Issue 4/2017

Medical Oncology 4/2017 Go to the issue

Original Paper

Alternative Chk1-independent S/M checkpoint in somatic cells that prevents premature mitotic entry

Original Paper

Chemotherapy for ovarian cancer in the Netherlands: a population-based study on treatment patterns and outcomes

Short Communication

Safety of herbal medicine use during chemotherapy in patients with ovarian cancer: a “bedside-to-bench” approach

Original Paper

Polymorphism in XRCC1 gene modulates survival and clinical outcomes of advanced North Indian lung cancer patients treated with platinum-based doublet chemotherapy

Review Article

Pharmacogenomics of platinum-based chemotherapy in non-small cell lung cancer: focusing on DNA repair systems

Review Article

Clinical outcome and molecular characterization of brain metastases from esophageal and gastric cancer: a systematic review

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits