Choice of Intra-arterial Therapy for Hepatocellular Carcinoma: Evidence and Future Horizons

摘要: Hepatocellular carcinoma is the second most common cause of cancer-related deaths worldwide. Along with viral and alcoholic hepatitis, obesity leading for increasing incidence in western world, specifically United States. As patients initially present intermediate to advanced stage disease, curative therapies such as ablation, surgical resection, or liver transplantation cannot usually be applied. Thus, intra-arterial (IATs), transarterial chemoembolization (TACE), have become a mainstay treatment. Several variations embolotherapy, bland embolization drug-eluting bead TACE, are currently available used clinical practice. Yttrium-90 radioembolization distinct IAT that relies on delivery radiation surrounding tissue tumor death. However, no clear guidelines evidence exist would favor one these options over other, leaving decision-making process open influence by local expertise experience. In addition, combining TACE systemic antiangiogenic agents, multityrosine kinase inhibitor sorafenib, has been investigated several prospective trials without clearly demonstrating substantial survival benefits combination alone. This review will summarize discuss indications each treatment modality goal facilitating processes, provide an overview ongoing efforts compare different modalities.