2nd Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece.
Department of Interventional Radiology, Aberdeen Royal Infirmary Hospital, NHS Grampian, Aberdeen, UK.
Expert Rev Med Devices. 2023 Apr;20(4):293-302. doi: 10.1080/17434440.2023.2185137. Epub 2023 Mar 5.
Liver-dominant metastatic colorectal cancer is noted in approximately 20%-35% of the patients. Systemic chemotherapy remains the first-line treatment for mCRC, but the prognosis is poor due to liver failure. Novel minimally invasive technologies have enabled the optimization of locoregional treatment options.
This is a comprehensive review of novel locoregional treatment technologies, both percutaneous ablation and transcatheter arterial treatments, which can be used to decrease hepatic disease progression in patients with mCRC. Trans-arterial radioembolization is the most recently developed locoregional treatment for metastatic liver disease, and robust evidence has been accumulated over the past years.
Image-guided techniques, endovascular and ablative, have gained wide acceptance for the treatment of liver malignancies, in selected patients with non-resectable disease. The optimization of dosimetry and microsphere technological advancement will certainly upgrade the role of liver radioembolization segmentectomy or lobectomy in the upcoming years, due to its curative intent. Also, ablative interventions provide local curative intent, offering significant and sustained local tumor control. Standardization protocols in terms of predictability and reliability using immediate treatment assessment and ablation zone software could further ameliorate clinical outcomes.
约 20%-35%的患者存在肝主导型转移性结直肠癌。系统化疗仍然是 mCRC 的一线治疗方法，但由于肝功能衰竭，预后较差。新型微创技术使局部区域治疗选择得到了优化。
这是对新型局部区域治疗技术的全面综述，包括经皮消融和经导管动脉治疗，这些技术可用于减少 mCRC 患者的肝疾病进展。经动脉放射性栓塞治疗是治疗转移性肝疾病的最新局部区域治疗方法，在过去几年中积累了大量证据。
在选择的不可切除疾病患者中，影像引导技术、血管内和消融技术已广泛用于治疗肝脏恶性肿瘤。由于其治疗意图，剂量学优化和微球技术的进步肯定会提升肝放射性栓塞术、肝段切除术或肝叶切除术在未来几年的作用。此外，消融干预提供局部根治性治疗，可显著和持续控制局部肿瘤。使用即时治疗评估和消融区域软件的可预测性和可靠性标准化方案可以进一步改善临床结果。
