An update on locoregional percutaneous treatment technologies in colorectal cancer liver metastatic disease.

IF 2.9 3区 医学 Q3 ENGINEERING, BIOMEDICAL
Stavros Spiliopoulos, Ornella Moschovaki-Zeiger, Akshay Sethi, George Festas, Lazaros Reppas, Dimitris Filippiadis, Nikolaos Kelekis
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引用次数: 0

Abstract

Introduction: Liver-dominant metastatic colorectal cancer is noted in approximately 20%-35% of the patients. Systemic chemotherapy remains the first-line treatment for mCRC, but the prognosis is poor due to liver failure. Novel minimally invasive technologies have enabled the optimization of locoregional treatment options.

Areas covered: This is a comprehensive review of novel locoregional treatment technologies, both percutaneous ablation and transcatheter arterial treatments, which can be used to decrease hepatic disease progression in patients with mCRC. Trans-arterial radioembolization is the most recently developed locoregional treatment for metastatic liver disease, and robust evidence has been accumulated over the past years.

Expert opinion: Image-guided techniques, endovascular and ablative, have gained wide acceptance for the treatment of liver malignancies, in selected patients with non-resectable disease. The optimization of dosimetry and microsphere technological advancement will certainly upgrade the role of liver radioembolization segmentectomy or lobectomy in the upcoming years, due to its curative intent. Also, ablative interventions provide local curative intent, offering significant and sustained local tumor control. Standardization protocols in terms of predictability and reliability using immediate treatment assessment and ablation zone software could further ameliorate clinical outcomes.

结直肠癌肝转移性疾病局部经皮治疗技术的最新进展
简介:约20%-35%的患者发生肝显性转移性结直肠癌。全身化疗仍是mCRC的一线治疗方法,但由于肝功能衰竭,预后较差。新颖的微创技术使局部区域治疗方案得以优化。涵盖领域:这是一篇全面回顾新的局部区域治疗技术,包括经皮消融和经导管动脉治疗,可用于减少mCRC患者的肝脏疾病进展。经动脉放射栓塞是最近发展起来的局部治疗转移性肝病的方法,并且在过去几年中积累了强有力的证据。专家意见:图像引导技术,血管内和消融技术,已被广泛接受用于治疗肝脏恶性肿瘤,在一些不可切除的疾病患者中。剂量学的优化和微球技术的进步必将在未来几年提升肝放射栓塞、节段切除术或肺叶切除术的作用,因为它的治疗目的。此外,消融干预提供局部治疗意图,提供显著和持续的局部肿瘤控制。使用即时治疗评估和消融区软件的可预测性和可靠性方面的标准化方案可以进一步改善临床结果。
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来源期刊
Expert Review of Medical Devices
Expert Review of Medical Devices 医学-工程:生物医学
CiteScore
5.90
自引率
3.20%
发文量
69
审稿时长
6-12 weeks
期刊介绍: The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.
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