New frontiers in endovascular therapies for locally advanced hepatocellular carcinoma

Abstract

Hepatocellular carcinoma is the most common primary malignant liver tumour and is a leading cause of death worldwide. Despite the advent of screening programmes, most cases of hepatocellular carcinoma are diagnosed late (in an advanced stage) which precludes curative treatments such as surgery and ablation. Therefore, intra-arterial locoregional treatments now play a central role in the management of advanced hepatocellular carcinoma, such treatments ranging from trans-arterial chemo-embolisation to the more recently developed trans-arterial radio-embolisation technique. In this essay, we discuss the state of the art of intra-arterial treatment for locally advanced hepatocellular carcinoma and the future directions for such treatment.

Transcatheter arterial infusion chemotherapy and embolization for primary lacrimal sac squamous cell carcinoma: A case report

“…Digital subtraction angiography–guided arterial infusion chemotherapy and embolization of tumor-supplying arteries have provided a new treatment method for neoplastic lesions[ 3 , 4 ]. Here, we present a case of primary lacrimal sac squamous cell carcinoma treated with transcatheter arterial infusion chemotherapy and interventional embolization, which showed good efficacy, thus providing a reference for the treatment of primary lacrimal sac tumors.…”

Locoregional therapies for the treatment of locally advanced hepatocellular carcinoma

“…For several decades, the gold standard treatment for intermediate (BCLC stage B) HCC is TACE, which can be performed using different techniques ( 5 ) : with particles of varying sizes, calibrated or not; with lipiodol (cTACE); or with a variety of chemotherapeutic agents (typically doxorubicin). It can be performed in a single session or over multiple sessions (two to three, on average), depending on the response of the patient ( 5 ) . More recently, DEB-TACE was developed in order to improve the results of TACE for HCC.…”

“…In patients with HCC classified as intermediate or advanced (BCLC stage B or C) who are not candidates for TACE or for treatment with sorafenib, the treatment most often employed is SIRT ( 5 ) . However, it is a costly treatment and is not widely available.…”

“…Interventional radiology plays a major role in the treatment of HCC. For those who wish to gain a better understanding of these therapeutic modalities, I recommend reading the article authored by Inchingolo et al ( 5 ) , published in the previous issue of Radiologia Brasileira, which artfully summarizes the advantages and disadvantages of each of the methods mentioned here.…”