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Interventionelle Therapie primärer Lebertumoren

Interventional therapy of primary liver tumors

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Der vorliegende Beitrag befasst sich mit der Vorstellung interventioneller Therapieverfahren wie transarterielle Chemoembolisation (TACE), selektive interne Radiotherapie (SIRT), Radiofrequenzablation (RFA), laserinduzierte Thermotherapie (LITT) und Mikrowellenablation (MWA) für die palliative Therapie von malignen primären Lebertumoren wie dem hepatozellulären Karzinom (HCC) und dem intrahepatischen Cholangiokarzinom (ICC). Da zum Zeitpunkt der Diagnosestellung viele Patienten mit einem HCC oder ICC als inoperabel eingestuft werden, stellen die interventionell-onkologischen Verfahren neben der systemischen Chemotherapie wichtige Therapieformen dar. Erläutert werden die allgemeinen technischen Grundlagen dieser Verfahren sowie die jeweiligen Einsatzbereiche und Voraussetzungen. Neben den Vorteilen und Resultaten wird auch auf die Kontraindikationen, Komplikationen und Nebenwirkungen eingegangen.

Abstract

The aim of this article is to present interventional therapy methods, such as transarterial chemoembolization (TACE), selective internal radiation therapy (SIRT), radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave ablation (MWA) for palliative therapy of primary malignant liver tumors, such as hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). At the time of diagnosis many patients with HCC and ICC do not have resectable tumors and in addition to systematic chemotherapy locoregional therapies become important alternative therapy options in the field of interventional oncology. The basic principles of these interventions, the respective application area and conditions are defined. In addition the advantages of the methods, results and also contraindications, complications and possible side effects are discussed.

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Literatur

  1. Anderson CD, Pinson CW, Berlin J, Chari RS (2004) Diagnosis and treatment of cholangiocarcinoma. Oncologist 9(1):43–57

    Article  PubMed  Google Scholar 

  2. Davis CR (2010) Interventional radiological treatment of hepatocellular carcinoma. Cancer Control 17(2):87–99 (Review)

    PubMed  Google Scholar 

  3. Gervais DA, Arellano RS (2011) Percutaneous tumor ablation for hepatocellular carcinoma. AJR Am J Roentgenol 197(4):789–794

    Article  PubMed  Google Scholar 

  4. Hilgard P, Müller S, Hamami M et al (2009) Selective internal radiotherapy (radioembolization) and radiation therapy for HCC–current status and perspectives. Z Gastroenterol 47(1):37–54

    Article  PubMed  CAS  Google Scholar 

  5. Ibrahim SM, Mulcahy MF, Lewandowski RJ et al (2008) Treatment of unresectable cholangiocarcinoma using yttrium-90 microspheres: results from a pilot study. Cancer 113(8):2119–2128

    Article  PubMed  CAS  Google Scholar 

  6. Jakobs TF, Hoffmann RT, Tatsch K et al (2008) Therapy response of liver tumors after selective internal radiation therapy. Radiologe 48(9):839–849

    Article  PubMed  CAS  Google Scholar 

  7. Kagawa T, Koizumi J, Kojima S-I et al (2010) Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma: comparison with surgical resection. Cancer 116(15):3638–3644

    Article  PubMed  Google Scholar 

  8. Kim JH, Won HJ, Shin YM et al (2011) Radiofrequency ablation for the treatment of primary intrahepatic cholangiocarcinoma. AJR. Am J Roentgenol 196(2):W205–209

    Article  Google Scholar 

  9. Lencioni R, Chen X-P, Dagher L, Venook AP (2010) Treatment of intermediate/advanced hepatocellular carcinoma in the clinic: how can outcomes be improved? Oncologist 15(Suppl 4):42–52

    Article  PubMed  CAS  Google Scholar 

  10. Liang P, Wang Y (2007) Microwave ablation of hepatocellular carcinoma. Oncology 72(Suppl 1):124–131

    Article  PubMed  Google Scholar 

  11. Livraghi T, Mäkisalo H, Line P-D (2011) Treatment options in hepatocellular carcinoma today. Scand J Surg 100(1):22–29

    PubMed  CAS  Google Scholar 

  12. Mensel B, Weigel C, Heidecke C-D et al (2005) Laser-induced thermotherapy (LITT) of tumors of the liver in central location: results and complications. Rofo 177(9):1267–1275

    Article  PubMed  CAS  Google Scholar 

  13. Rempp H, Boss A, Helmberger T, Pereira P (2011) The current role of minimally invasive therapies in the management of liver tumors. Abdom Imaging 36(6):35–47

    Article  Google Scholar 

  14. Rossi L, Zoratto F, Papa A et al (2010) Current approach in the treatment of hepatocellular carcinoma. World J Gastrointest Oncol 2(9):348–359

    Article  PubMed  Google Scholar 

  15. Saxena A, Bester L, Chua TC et al (2010) Yttrium-90 radiotherapy for unresectable intrahepatic cholangiocarcinoma: a preliminary assessment of this novel treatment option. Ann Surg Oncol 17(2):484–491

    Article  PubMed  Google Scholar 

  16. Vogl TJ, Lammer J, Lencioni R et al (2011) Liver, gastrointestinal, and cardiac toxicity in intermediate hepatocellular carcinoma treated with PRECISION TACE with drug-eluting beads: results from the PRECISION V Randomized Trial. AJR Am J Roentgenol 197(4):W562–W570

    Article  PubMed  Google Scholar 

  17. Vogl TJ, Mack M, Straub R et al (2000) Percutaneous interstitial thermotherapy of malignant liver tumors. Rofo 172(1):12–22

    Article  PubMed  CAS  Google Scholar 

  18. Vogl TJ, Müller PK, Mack MG et al (1999) Therapeutic options in non-resectable liver metastases. Percutaneous radiological interventions. Chirurg 70(2):133–140

    Article  PubMed  CAS  Google Scholar 

  19. Vogl TJ, Naguib NNN, Nour-Eldin N-E et al (2011) Transarterial chemoembolization in the treatment of patients with unresectable cholangiocarcinoma: results and prognostic factors governing treatment success. Int J Cancer (Aug 30, online)

  20. Vogl TJ, Naguib NNN, Nour-Eldin N-EA et al (2009) Review on transarterial chemoembolization in hepatocellular carcinoma: palliative, combined, neoadjuvant, bridging, and symptomatic indications. Eur J Radiol 72(3):505–516

    Article  PubMed  Google Scholar 

  21. Vogl TJ, Schwarz W, Eichler K et al (2006) Hepatic intraarterial chemotherapy with gemcitabine in patients with unresectable cholangiocarcinomas and liver metastases of pancreatic cancer: a clinical study on maximum tolerable dose and treatment efficacy. J Cancer Res Clin Oncol 132(11):745–755

    Article  PubMed  CAS  Google Scholar 

  22. Vogl TJ, Straub R, Eichler K et al (2002) Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: experience with complications in 899 patients (2,520 lesions). Radiology 225(2):367–377

    Article  PubMed  Google Scholar 

  23. Vogl TJ, Zangos S, Balzer JO et al (2007) Transarterial chemoembolization (TACE) in hepatocellular carcinoma: technique, indication and results. Rofo 179(11):1113–1126

    Article  PubMed  CAS  Google Scholar 

  24. Yin XY, Xie XY, Lu M-D et al (2009) Percutaneous thermal ablation of medium and large hepatocellular carcinoma: long-term outcome and prognostic factors. Cancer 115(9):1914–1923

    Article  PubMed  CAS  Google Scholar 

  25. Zhang Z-M, Guo JX, Zhang ZC et al (2011) Therapeutic options for intermediate-advanced hepatocellular carcinoma. World J Gastroenterol 17(13):1685–1689

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt/Main, Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland

    T.J. Vogl, F. Marquardt, N.N.N. Naguib, T. Gruber-Rouh, M. Beeres & C. Lee

  2. Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Frankfurt/Main, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt/Main, Deutschland

    W. Bechstein

  3. Medizinische Klinik I: Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt/Main, Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt/Main, Deutschland

    J. Trojan

Authors
  1. T.J. Vogl
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  2. F. Marquardt
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  3. W. Bechstein
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  4. J. Trojan
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  5. N.N.N. Naguib
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  6. T. Gruber-Rouh
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  7. M. Beeres
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  8. C. Lee
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Correspondence to T.J. Vogl.

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Vogl, T., Marquardt, F., Bechstein, W. et al. Interventionelle Therapie primärer Lebertumoren. Onkologe 18, 593–601 (2012). https://doi.org/10.1007/s00761-012-2237-7

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  • DOI: https://doi.org/10.1007/s00761-012-2237-7

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