Critical review of multidisciplinary non-surgical local interventional ablation techniques in primary or secondary liver malignancies

Abstract

Local non-surgical interventional percutaneous ablation represents nowadays an important part of the potential treatment strategies. Although surgical ablation represents the gold standard, in the past decade there was an expansion in the use of non-surgical ablative techniques: radiofrequency, microwave, laser, cryoablation, irreversible electroporation, and interventional radiotherapy (brachytherapy) in primary as well as secondary liver cancers. With the growing experience in the field, there was implemented a new pillar for cancer treatment, together with surgery, chemotherapy as well as radiotherapy, so-called interventional oncology (IO). To date, there are no published papers regarding a comparative interdisciplinary evaluation of all these non-surgical interventional local ablation therapies. Our paper offers a critical interdisciplinary overview of the treatments in both primary and secondary liver tumors, including from a cost-effective point of view. Furthermore, the present status of education in IO and a comparison of actual economic aspects of the treatments are also provided.

Iodine-125 seed implantation for residual hepatocellular carcinoma or cholangiocellular carcinoma in challenging locations after transcatheter arterial chemoembolization. Initial experience and findings

“…Some studies have reported that treatment with TACE and subsequent CT-HDRBT results are associated with a very promising survival rate for patients with unresectable HCC [ 35 ]. From the economic perspective, CT-HDRBT is less expensive than RFA and MWA [ 36 ]. Therefore, the combination of CT-HDRBT with TACE offers a dual advantage in the treatment of tumors.…”

Single-fraction image-guided high-dose-rate brachytherapy for head and neck cancer: three cases of palliative brachytherapy

“…The dose ranging from 15 to 20 Gy is generally used as a single-fraction HDR brachytherapy to liver, kidney, lung, and breast malignancies [ 10 , 11 , 12 , 13 ]. However, an appropriate single-fraction dose for head and neck cancer in palliative therapy is unknown.…”

Stereotactic Ablative Brachytherapy: Recent Advances in Optimization of Radiobiological Cancer Therapy

“…During the last decade, ablative radiotherapy has been revolutionized. BT approach in patients with liver tumors had been modernized and ablative BT was increasingly used as a non-thermal ablation [ 111 , 112 ].…”

“…In patients with liver cancer, BT application allows achieving an excellent local tumor control of up to 96.1% [ 112 ]. Moreover, BT delivered higher survival benefit compared to the best supportive care (median overall survival 23 months vs. 5 months) in those patients [ 112 ].…”