title: Chemoembolization in colorectal liver metastases: the rebirth.
abstract: Currently image-guided trans-arterial chemoembolization (TACE) has a significant role in the therapy of patients with hepatocellular carcinoma and liver metastases. This endovascular hepatic-directed therapy offers the dual benefit of true local neoplastic control and reduction of side-effects. As a result, it has been included in the guidelines for primary liver cancer and is often considered as salvage therapy for patients liver metastases from neuroendocrine and chemorefractory colorectal tumors. The development of new embolizing agents, such as DC beads loaded with doxorubicin and irinotecan, permits better standardization and definition of protocols, making the procedures less linked to criteria of different hospitals and personal experiences of interventional radiologists. The understanding that hypoxia induces vessel re-growth will open a new avenue for clinical research and a rebirth for TACE. Chemoembolization followed by target therapy (bevacizumab, aflibercept and regorafenib) could increase quality, duration of responses and better quality of life.
authors: Oncology Unit, Department of Oncology-Hematology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, via Cesare Lombroso 1, 61121 Pesaro (PU), Italy. g.fiorentini@alice.it.
authors: Giammaria
authors: G
authors: Fiorentini
authors: Camillo
authors: C
authors: Aliberti
authors: Luca
authors: L
authors: Mulazzani
authors: Paolo
authors: P
authors: Coschiera
authors: Vincenzo
authors: V
authors: Catalano
authors: David
authors: D
authors: Rossi
authors: Paolo
authors: P
authors: Giordani
authors: Stefano
authors: S
authors: Ricci
mesh_terms: D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*
keywords: DEBIRI; KRAS; Liver metastases; aflibercept; cetuximab; chemoembolization; colorectal cancer; drug-eluting beads; irinotecan; regorafenib; review