Liver-Directed Therapies for Primary and Metastatic Disease: Radioembolization and Chemoembolization

摘要

Anatomically targeted treatments for focal tumors have been a mainstay of oncologic treatment for generations. Surgical resection and radiotherapy are frequently not feasible for hepatic malignancies, though, where multifocality, compromised liver function, and hepatic radiosensitiv-ity limit the applications of these options. By exploiting the dual blood supply to the liver with preferential arterial (vs. portal venous) supply to malignancies, high dose chemotherapy, or radiation may be delivered in an anatomically and physiologically targeted fashion via the intra-arterial route to intrahepatic tumors, with limited systemic and organic toxicity. Indications, patient selection, treatment algorithms, agents, and vehicles continue to evolve.