Advances in regional chemotherapy of the liver
Source: Expert Opinion on Drug Delivery, Volume 8, Number 8, August 2011 , pp. 1057-1069(13)
Publisher: Informa Healthcare
Abstract:Introduction: Primary and secondary liver tumors resemble some of the most common causes of cancer and represent a major clinical problem owing to the poor prognosis. First-line therapeutic concepts are mainly based on surgical resection and/or systemic chemotherapy (SCT). However, many patients are not suitable for surgery or have failed SCT, although the total tumor load is still limited, which makes a regional therapy approach appealing. Areas covered: This review focuses on different types of transarterial instillation of chemotherapy, which encompasses conventional and drug-eluting transarterial chemoembolization (TACE), hepatic arterial infusion (HAI) chemotherapy and isolated hepatic perfusion (ILP). Expert opinion: TACE can be regarded as the treatment of choice in patients with multinodular hepatocellular carcinoma, but it should still be performed as a lipiodol-based regimen, while the value of doxorubicin-eluting beads needs to be exploited in further randomized controlled trials (RCTs). For patients with colorectal liver metastases, HAI chemotherapy has been challenged by the advent of more effective SCT, but encouraging results have been observed for the combination of the most recent, active drugs given by means of HAI with SCT. Nevertheless, data from RCTs comparing SCT with this transarterial regional therapy approach, as well as with TACE and ILP, are urgently needed.
Document Type: Research article
Affiliations: 1: 1Priv.-Doz., University of Magdeburg, Department of Radiology and Nuclear Medicine, Leipziger Strasse 44, 39120 Magdeburg, Germany ++49 391 67 13030; ++49 391 67 13029;, Email: email@example.com 2: 2University of Magdeburg, Department of Radiology and Nuclear Medicine, Leipziger Strasse 44, 39120 Magdeburg, Germany
Publication date: 2011-08-01