Kovács Attila, Iezzi Roberto, Cellini Francesco, Lancellotta Valentina, Bischoff Peter, Carchesio Francesca, Tagliaferri Luca, Kovács György, Gambacorta Maria Antonietta
Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Mediclin Robert Janker Klinik, Bonn, Germany.
Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italia.
J Contemp Brachytherapy. 2019 Dec;11(6):589-600. doi: 10.5114/jcb.2019.90466. Epub 2019 Dec 8.
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.
如今,局部非手术介入性经皮消融是潜在治疗策略的重要组成部分。尽管手术消融是金标准,但在过去十年中,非手术消融技术的应用有所扩展:包括射频、微波、激光、冷冻消融、不可逆电穿孔以及原发性和继发性肝癌的介入放射治疗(近距离放射治疗)。随着该领域经验的不断积累,除了手术、化疗和放疗外,癌症治疗领域还出现了一个新的支柱,即所谓的介入肿瘤学(IO)。迄今为止,尚无关于所有这些非手术介入局部消融疗法的比较性跨学科评估的发表论文。我们的论文从成本效益的角度对原发性和继发性肝肿瘤的治疗进行了批判性的跨学科概述。此外,还介绍了介入肿瘤学的教育现状,并对治疗的实际经济方面进行了比较。