Limits...
Minimally invasive local therapies for liver cancer.

Li D, Kang J, Golas BJ, Yeung VW, Madoff DC - Cancer Biol Med (2014)

Bottom Line: For patients with low volume disease, these therapies have now been established into consensus practice guidelines.This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT).In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, USA ; 2 Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA ; 3 Flushing Radiation Oncology Services, Flushing, New York, NY 11354, USA ; 4 Department of Surgery, Division of Surgical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center New York, New York, NY 10065, USA.

ABSTRACT
Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have filled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

No MeSH data available.


Related in: MedlinePlus

A 61-year-old male with history of localized rectal cancer treated with chemoradiation and surgery; subsequently diagnosed 2 years later with isolated liver lesion growing in size and avidity, biopsied positive for metastatic rectal cancer. Patient initially refused all invasive procedures including surgery, opting for chemotherapy alone, then ultimately agreed to SBRT. (A) Pretreatment axial fused PET-CT image demonstrating metastatic segment 7 liver lesion with SUV 3.8 (arrow). (B) Treatment plan depicting prescription isodose line (in red) with rapid dose fall off around the tumor. (C) Axial fused PET-CT obtained 18 months after SBRT demonstrating no evidence of disease. (D) Axial contrast enhanced CT image obtained 4 years after SBRT demonstrating no evidence of disease. SBRT, stereotactic body radiation therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4296086&req=5

f6: A 61-year-old male with history of localized rectal cancer treated with chemoradiation and surgery; subsequently diagnosed 2 years later with isolated liver lesion growing in size and avidity, biopsied positive for metastatic rectal cancer. Patient initially refused all invasive procedures including surgery, opting for chemotherapy alone, then ultimately agreed to SBRT. (A) Pretreatment axial fused PET-CT image demonstrating metastatic segment 7 liver lesion with SUV 3.8 (arrow). (B) Treatment plan depicting prescription isodose line (in red) with rapid dose fall off around the tumor. (C) Axial fused PET-CT obtained 18 months after SBRT demonstrating no evidence of disease. (D) Axial contrast enhanced CT image obtained 4 years after SBRT demonstrating no evidence of disease. SBRT, stereotactic body radiation therapy.

Mentions: SBRT is a recently developed technique that allows high conformal radiation treatment by utilizing multiple, non-coplanar beams or arcs to target the tumor with millimeter precision. Compared to standard external beam radiation (3-D or intensity modulated RT), SBRT can create a rapid radiation dose fall off, allowing ablative radiation doses to be delivered to gross tumors while sparing adjacent tissue (Figure 6). As a result, SBRT has emerged as the primary technique of delivering radiation to liver tumors.


Minimally invasive local therapies for liver cancer.

Li D, Kang J, Golas BJ, Yeung VW, Madoff DC - Cancer Biol Med (2014)

A 61-year-old male with history of localized rectal cancer treated with chemoradiation and surgery; subsequently diagnosed 2 years later with isolated liver lesion growing in size and avidity, biopsied positive for metastatic rectal cancer. Patient initially refused all invasive procedures including surgery, opting for chemotherapy alone, then ultimately agreed to SBRT. (A) Pretreatment axial fused PET-CT image demonstrating metastatic segment 7 liver lesion with SUV 3.8 (arrow). (B) Treatment plan depicting prescription isodose line (in red) with rapid dose fall off around the tumor. (C) Axial fused PET-CT obtained 18 months after SBRT demonstrating no evidence of disease. (D) Axial contrast enhanced CT image obtained 4 years after SBRT demonstrating no evidence of disease. SBRT, stereotactic body radiation therapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296086&req=5

f6: A 61-year-old male with history of localized rectal cancer treated with chemoradiation and surgery; subsequently diagnosed 2 years later with isolated liver lesion growing in size and avidity, biopsied positive for metastatic rectal cancer. Patient initially refused all invasive procedures including surgery, opting for chemotherapy alone, then ultimately agreed to SBRT. (A) Pretreatment axial fused PET-CT image demonstrating metastatic segment 7 liver lesion with SUV 3.8 (arrow). (B) Treatment plan depicting prescription isodose line (in red) with rapid dose fall off around the tumor. (C) Axial fused PET-CT obtained 18 months after SBRT demonstrating no evidence of disease. (D) Axial contrast enhanced CT image obtained 4 years after SBRT demonstrating no evidence of disease. SBRT, stereotactic body radiation therapy.
Mentions: SBRT is a recently developed technique that allows high conformal radiation treatment by utilizing multiple, non-coplanar beams or arcs to target the tumor with millimeter precision. Compared to standard external beam radiation (3-D or intensity modulated RT), SBRT can create a rapid radiation dose fall off, allowing ablative radiation doses to be delivered to gross tumors while sparing adjacent tissue (Figure 6). As a result, SBRT has emerged as the primary technique of delivering radiation to liver tumors.

Bottom Line: For patients with low volume disease, these therapies have now been established into consensus practice guidelines.This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT).In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, USA ; 2 Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA ; 3 Flushing Radiation Oncology Services, Flushing, New York, NY 11354, USA ; 4 Department of Surgery, Division of Surgical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center New York, New York, NY 10065, USA.

ABSTRACT
Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have filled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

No MeSH data available.


Related in: MedlinePlus