Radiotherapy Department, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
Med Oncol. 2020 Apr 29;37(6):52. doi: 10.1007/s12032-020-01377-7.
Non-surgical locally ablative treatments for primary liver cancer and liver metastases represent an effective therapeutic choice when surgery cannot be performed or is not indicated. Thermal ablative employing electric currents or electromagnetic fields have historically played an important role in this setting. Radiotherapy, in the last decades, due to a series of important technological development, has become an attractive option for the treatment of liver tumours, especially with the introduction of Stereotactic Body Radiotherapy. Published literature so far evidenced both for radiotherapy and thermal ablative techniques a benefit in terms of local control and other oncological outcomes; however, no direct prospective comparison between the two techniques have been published so far. The aim of this review is to summarize the technical and clinical implications of these treatment modalities and to identify criteria to allocate patients to one or another option in consideration of the expected efficacy. The main features and critical aspects of both thermoablative techniques and external beam radiation will also be covered in the present paper.
当手术不可行或不适用时，非手术局部消融治疗原发性肝癌和肝转移瘤是一种有效的治疗选择。在这种情况下，历史上采用电流或电磁场的热消融技术发挥了重要作用。放射治疗在过去几十年中，由于一系列重要的技术发展，已成为治疗肝肿瘤的一种有吸引力的选择，特别是立体定向体部放射治疗的引入。到目前为止，发表的文献表明，放射治疗和热消融技术在局部控制和其他肿瘤学结果方面都有获益；然而，目前还没有这两种技术的直接前瞻性比较。本文的目的是总结这些治疗方式的技术和临床意义，并确定将患者分配到一种或另一种治疗方式的标准，以考虑预期的疗效。本文还将介绍热消融技术和外照射放疗的主要特点和关键方面。
