The Management of Colorectal Cancer Liver Metastases: The Interventional Radiology Viewpoint

Rice, Samuel L.; Bale, Reto; Breen, David J.; Baère, Thierry De; Denys, Alban; Guiu, Boris; Goldberg, Nahum; Kim, Edward; Lewandowski, Robert J.; Helmberger, Thomas; Mejerjink, Martijn; Pereira, Philippe L.; Solbiati, Luigi; Solomon, Stephen B.; Sofocleous, Constantinos T.

doi:10.1016/j.ijrobp.2018.08.069

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Percutaneous ablation destructs the target tumor with a safety margin of normal parenchyma sparing the uninvolved hepatic tissue. This is in opposition to SBRT application that affects a greater amount of normal liver parenchyma via the surrounding radiation portals with resultant liver toxicity [65]. Repeat treatment with SBRT is thus more likely to lead to liver toxicity or even failure.…”

Section: Comparing Percutaneous Ablation To Other Therapiesmentioning

confidence: 99%

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

et al. 2021

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Approximately 50% of colorectal cancer patients will develop metastases during the course of the disease. Local or locoregional therapies for the treatment of liver metastases are used in the management of oligometastatic colorectal liver disease, especially in nonsurgical candidates. Thermal ablation (TA) is recommended in the treatment of limited liver metastases as free-standing therapy or in combination with surgery as long as all visible disease can be eradicated. Percutaneous TA has been proven as a safe and efficacious therapy offering sustained local tumor control and improved patient survival. Continuous technological advances in diagnostic imaging and guidance tools, the evolution of devices allowing for optimization of ablation parameters, as well as the ability to perform margin assessment have improved the efficacy of ablation. This allows resectable small volume diseases to be cured with percutaneous ablation. The ongoing detailed information and increasing understanding of tumor biology, genetics, and tissue biomarkers that impact oncologic outcomes as well as their implications on the results of ablation have further allowed for treatment customization and improved oncologic outcomes even in those with more aggressive tumor biology. The purpose of this review is to present the most common indications for image-guided percutaneous ablation in colorectal cancer liver metastases, to describe technical considerations, and to discuss relevant peer-reviewed evidence on this topic. The growing role of imaging and image-guidance as well as controversies regarding several devices are addressed.

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Section: Comparing Percutaneous Ablation To Other Therapiesmentioning

confidence: 99%

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

et al. 2021

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“…An important difference between RFA and SBRT is repeatability. In contrast to RFA, repeated use of SBRT is limited for new HCC lesions due to the decreased liver function after SBRT [31]. Considering that frequent intrahepatic recurrences of HCC require repeated treatments, SBRT might be spared for lesions unsuitable for other liver-directed treatments.…”

Section: Clinical Considerationsmentioning

confidence: 99%

Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma

Park

Kang

2019

Yeungnam Univ J Med

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Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

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“…8 Many patients referred for SBRT present with larger lesions than those considered optimal for thermal ablation ( 3 cm) and with tumors for which curative ablation with adequate margins (!6 mm) is not feasible. 9,10 Several studies on SBRT for liver metastases reported a 3-year local control of 66% to 91% and a 3year overall survival of 27% to 65%. [11][12][13] Severe toxicity (grade !3) was limited, and the treatment appeared to be safe.…”

Section: Introductionmentioning

confidence: 99%

The Dutch–Belgian Registry of Stereotactic Body Radiation Therapy for Liver Metastases: Clinical Outcomes of 515 Patients and 668 Metastases

Romero

Schillemans

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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The Management of Colorectal Cancer Liver Metastases: The Interventional Radiology Viewpoint

Cited by 4 publications

References 10 publications

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease

Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma

The Dutch–Belgian Registry of Stereotactic Body Radiation Therapy for Liver Metastases: Clinical Outcomes of 515 Patients and 668 Metastases

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