Chemoembolization and radioembolization

Abstract Chemoembolization and radioembolization are at the core of the treatment of patients with hepatocellular carcinoma who cannot receive potentially curative therapies such as transplantation, resection or percutaneous ablation. They differ in the mechanism of action (ischaemia and increase cy...

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Published inBaillière's best practice & research. Clinical gastroenterology Vol. 28; no. 5; pp. 909 - 919
Main Author Sangro, Bruno, MD, PhD
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.10.2014
Elsevier Limited
Subjects
Antineoplastic Agents - administration & dosage
Carcinoma, Hepatocellular - therapy
Cytotoxicity
Drug-eluting beads, DEB
Embolization, Therapeutic - methods
Gastroenterology and Hepatology
Humans
Liver cirrhosis
Liver Neoplasms - therapy
Medical prognosis
Mortality
Patients
Polyvinyl alcohol
Radioembolization, RE
Radiopharmaceuticals - administration & dosage
Selective Internal Radiation Therapy, SIRT
Transarterial chemoembolization, TACE
Tumors
Yttrium
Radioembolization, RE
Yttrium
Transarterial chemoembolization, TACE
Drug-eluting beads, DEB
Selective Internal Radiation Therapy, SIRT
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Summary:Abstract Chemoembolization and radioembolization are at the core of the treatment of patients with hepatocellular carcinoma who cannot receive potentially curative therapies such as transplantation, resection or percutaneous ablation. They differ in the mechanism of action (ischaemia and increase cytotoxic drug exposure for chemoembolization, internal irradiation for radioembolization) and may target different patient populations. Chemoembolization with cytotoxic drug-eluting beads is a more standardized although not necessarily more effective way of performing chemoembolization. Cytoreduction is achieved in most patients but complete tumor ablation may be achieved and lead to extended survival. Grade 1 level of evidence support the use of chemoembolization for the treatment of patients in the early and intermediate stages while grade 2 evidence supports the use of radioembolization for the treatment of patients in intermediate to advanced stages. Selecting the best candidates for both techniques is still a work in progress that ongoing clinical trials are trying to address.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:1521-6918
1532-1916
DOI:10.1016/j.bpg.2014.08.009