The current practice of transarterial chemoembolization for the treatment of hepatocellular carcinoma.
Despite remarkable advancement in the surveillance and treatment of hepatocellular carcinoma (HCC) and the availability of novel curative options, a great proportion of HCC patients are still not eligible for curative treatment due to an advanced tumor stage or poor hepatic functional reserve. Therefore, there is a continuing need for effective palliative treatments. Although practiced widely, it has only recently been demonstrated that the use of transarterial chemoembolization (TACE) provides a survival benefit based on randomized controlled studies. Hence, TACE has become standard treatment in selected patients. TACE combines the effect of targeted chemotherapy with the effect of ischemic necrosis induced by arterial embolization. Most of the TACE procedures have been based on iodized oil utilizing the microembolic and drug-carrying characteristic of iodized oil. Recently, there have been efforts to improve the delivery of chemotherapeutic agents to a tumor. In this review, the basic principles, technical issues and complications of TACE are reviewed and recent advancement in TACE technique and clinical applicability are briefed.
Shin
Sung Wook
SW
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. swshin@skku.edu
D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000628:therapy*
D000970:Antineoplastic Agents; D007459:Iodized Oil