Interventional Radiology for Colorectal Liver Metastases

AbstractPurpose of the ReviewTo discuss the pivotal role of Interventional radiology (IR) for the management of colorectal liver metastases (CRLM).Recent FindingsIR has three main objectives for the treatment of CRLM:Complete tumor destruction using percutaneous ablation, as an alternative to or more frequently in combination with surgeryIntra-arterial therapies to improve objective response rate and to prolong survivalAll support therapies such as portal vein embolization or fiducial placement to allow or facilitate further treatmentsSummaryRadiofrequency ablation (RFA) is the most reported percutaneous ablation technique and provides high local control rates that exceed 90% for small metastases (<  3 cm). Novel technologies such as microwave ablation could help overcome some limitations of RFA. Liver metastases non-amenable to radical treatment can, because of their arterial supply, be targeted with hepatic arterial infusion chemotherapy (HAIC) or selective internal radiation therapy (SIRT ). HAIC has demonstrated encouraging response rates in patients who have previously failed intravenous chemotherapy or as adjuvant therapies to decrease post-operative recurrence rates. Although large SIRT trials are negative, there is a benefit in terms of progression-free survival in the liver whe n used as first-line treatment in combination with systemic therapy as well as in selected patients with advanced disease that justifies further interest in this technique. More recent d...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research