Transarteriel Kemoembolizasyon (TAKE)
Özet
Transarteriyel Kemoembolizasyon (TAKE), karaciğerin cerrahi veya ablasyon gibi küratif yöntemlere uygun olmayan primer (özellikle Hepatoselüler Karsinom - HCC) ve metastatik tümörlerinin tedavisinde kullanılan minimal invaziv bir girişimsel onkoloji yöntemidir. Bu tedavi, normal karaciğer parankiminin aksine karaciğer tümörlerinin yüksek oranda hepatik arterden beslenmesi prensibine dayanır. İşlem, kullanılan ajana göre Lipiodol içeren konvansiyonel TAKE (kTAKE) ve ilaç yüklenebilir mikrokürelerin kullanıldığı debTAKE olmak üzere ikiye ayrılır. TAKE, hastaların ortalama sağkalım sürelerini artırırken, tümör evresini gerileterek hastaları karaciğer nakli gibi küratif tedavilere taşıyan etkili bir köprü görevi de görür. İşlem sonrasında en sık post-embolizasyon sendromu (ateş, karın ağrısı, kusma) görülürken, tedavi yanıtı dinamik BT veya MRG gibi görüntüleme yöntemleriyle (mRECIST kriterleri) yakından takip edilir.
Transarterial Chemoembolization (TACE) is a minimally invasive interventional oncology method used for treating primary liver tumors (especially Hepatocellular Carcinoma - HCC) and metastatic liver tumors that are unsuitable for curative treatments like surgery or ablation. This treatment is based on the principle that liver tumors are predominantly supplied by the hepatic artery, unlike the normal liver parenchyma. The procedure is categorized into two main types depending on the agent used: conventional TACE (cTACE) utilizing Lipiodol, and debTACE which employs drug-eluting beads. TACE significantly extends the median survival rates of patients and acts as an effective bridging therapy for curative options, such as liver transplantation, by successfully downstaging the clinical tumor phase. Post-embolization syndrome (fever, abdominal pain, vomiting) is the most common side effect following the procedure, and treatment response is strictly monitored using dynamic CT or MRI imaging based on mRECIST criteria.
Referanslar
Solomon SB, Cornelis F. Interventional molecular imaging. J Nucl Med. 2016; 57(4):493-6
Doyon D, Mouzon A, Jourde AM, Regensberg C, Frileux C. Hepatic, arterial embolization in patients with malignant liver tumours (author’s transl). Ann Radiol (Paris). 1974;17:593-603.
Nakakuma K, Tashiro S, Hiraoka T, Uemura K, Konno T, Miyauchi Y, et al. Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer. Cance. 1983;52:2193-200.
de Baere T, Zhang X, Aubert B, Harry G, Lagrange C, Ropers J, et al. Quantification of tumor uptake of iodized oils and emulsions of iodized oils: experimental study. Radiology. 1996;201:731-5.
Bolondi L, Burroughs A, Dufour JP, ct al. Heterogeneity of patients with intermediate (BCLC B) Hepatoccllular Carcinoma: proposal for a subclassification to facilitate treatment decisions. Scmin Liver Dis 2012; 32:348-359.
de Baere, Thierry, d al. "Treatment of liver tumors with lipiodol TACE: technical recommendations from experts opinion.’’ Cardiovascular Intcrv Radiol 2016; 39(3):334-43.
Llovct JM, Real MI, Montana X, ct al. Arterial cmbolisation or chemoembolisation versus symptomatic treatment in patients with unrcsectablc hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359:1734-9.
Kan Z, Sato M, lvanccv K, et al. Distribution and effect of iodized poppyseed oil in the liver after hepatic artery embolization: experimental study in several animal species. Radiology 1993; 186:861-6.
Khan W, Sullivan KL, McCann JW, et al. Moxifloxacin prophyla.xis for chemocmbolization or embolization in patients with previous biliary interventions: a pilot study. AJR Am J Roentgenol 201l; 197:343-5.
Wang J, He XD ZY. Antibiotic prophylaxis in transarterial therapy ofhepatocellular carcinoma: a meta-analysis. Can J Gastroenterol 2012; 26(2): 85-91.
Ozkavukcu E, Haliloğlu N, Erden A. Post-treatment MRI findings of hepatocellular carcinoma. Diagn Interv Radiol. 2009;15:111- 20
Lim HS, Jeong YY, Kang HK, Kim JK, Park JG. Imaging features of hepatocellular carcinoma after transcatheter arterial chemoembolization and radiofrequency ablation. AJR Am J Roentgenol. 2006;187:341-9.
Yaghmai V, Besa C, Kim E, Gatlin JL, Siddiqui NA, Taouli B. Imaging assessment of hepatocellular carcinoma response to locoregional and systemic therapy. AJR Am J Roentgenol. 2013;201:80-96
Kamel IR, Liapi E, Reyes DK, Zahurak M, Bluemke DA, Geschwind JF. Unresectable hepatocellular carcinoma: serial early vascular and cellular changes after transarterial chemoembolization as detected with MR imaging. Radiology. 2009;250:466-73.
European Association For The Study Of The Liver; European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56: 908-43
Marelli L, Stigliano R, Triantos C, Senzolo M, Cholongitas E, Davies N, et al. Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol. 2007;30:6-25
Llovet JM BJ. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology 2003; 37(2):429-442.
Jelic S SG. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21:59-64.
Zhong JH LL. Postoperative adjuvant transarterial chemoembolization for participants with hepatocellular carcinoma: A meta-analysis. Hepatol Res 2010; 40:943-53.
Vogl TJ, Naguib NN, Nour-Eldin NE, et al. Review on transarterial chemoembolization in hepatocellular carcinoma: palliative, combined, neoadjuvant, bridging, and symptomatic indications. Eur J Radiol 2009; 72:505-16.
Chua TC, Liauw W, Saxena A, et al. Systematic review of neoadjuvant transarterial chemoembolization for resectable hepatocellular carcinoma. Liver Int 2010; 30: 166-7 4
Ozkavukcu E, Haliloğlu N, Erden A. Post-treatment MRI findings of hepatocellular carcinoma. Diagn Interv Radiol. 2009;15:111- 20
Lim HS, Jeong YY, Kang HK, Kim JK, Park JG. Imaging features of hepatocellular carcinoma after transcatheter arterial chemoembolization and radiofrequency ablation. AJR Am J Roentgenol. 2006;187:341-9
Yaghmai V, Besa C, Kim E, Gatlin JL, Siddiqui NA, Taouli B. Imaging assessment of hepatocellular carcinoma response to locoregional and systemic therapy. AJR Am J Roentgenol. 2013;201:80-96.
Kamel IR, Liapi E, Reyes DK, Zahurak M, Bluemke DA, Geschwind JF. Unresectable hepatocellular carcinoma: serial early vascular and cellular changes after transarterial chemoembolization as detected with MR imaging. Radiology. 2009;250:466-73.
Kawai S, Tani M, Okamura J, Ogawa M, Ohashi Y, Monden M, et al. Prospective and randomized trial of Lipiodol-transcatheter arterial chemoembolization for treatment of hepatocellular carcinoma: a comparison of epirubicin and doxorubicin (second cooperative study). The Cooperative Study Group for Liver Cancer Treatment of Japan. Semin Oncol. 1997;24:6-38-45.
Zhou WP, Lai EC, Li AJ, Fu SY, Zhou JP, Pan ZY, Lau WY and Wu MC. A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma. Ann Surg. 2009;249:195-202
Kaibori M, Tanigawa N, Kariya S, Ikeda H, Nakahashi Y,Hirohara J, et al. A prospective randomized controlled trial of preoperative whole-liver chemolipiodolization for hepatocellular carcinoma.Dig Dis Sci. 2012;57:1404- 12
Akamatsu M, Yoshida H, Obi S, Sato S, Koike Y, Fujishima T, el al. Evaluation of transcatheter arterial embolization prior to percutaneous tumor ablation in patients with hepatocellular carcinoma: a randomized controlled trial. Liver Int 2004;24(6):625-9
Wang W, Shi J, Xie WF. Transarterial che moembolization in combination with percutaneous ablation therapy in unresectable hepatocellular carcinoma: a meta-analysis. Liver Int. 2010;30(5):741-9
Lencioni R, Llovet JM, Han G, Tak WY, Yang J, Guglielmi A, et al. Sorafenib or placebo plus TACEwith doxorubicin-eluting beads for intermediate stage HCC: The SPACE trial. Journal of hepatology. 2016;64(5):10
Shamimi-Noori S, Gonsalves CF, Shaw CM. Metastatic liver disease: Indications for locore gional therapy and supporting data. Semin Intervent. Radiol. 2017;34:145-66.
Gordon AC, Uddin OM, Riaz A, Salem R, Lewandowski RJ. Making the case: intra-arterial therapy for less common metastases. Semin Intervent. Radiol. 2017;34:132-9.
Akinwande O, Dendy M, Ludwig JM, Kim HS. Hepatic intra-arterial injection of irinotecan drug eluting beads (DEBIRI) for patients with unresectable colorectal liver metastases: A systematic review. Surg Oncol. 2017;26(3): 268-75
Fiorentini G, Aliberti C, Mulazzani L, Coschiera P, Catalano V, Rossi D, et al. Chemoembolization in colorectal liver metastases: the rebirth. Anticancer Res. 2014; 34(2):575-84.
Xing M, Kooby DA, El-Rayes BF, Kokabi N, Camacho JC, Kim HS. Locoregional therapies for metastatic colorectal carcinoma to the liver - an evidence-based review. J Surg Oncol. 2014;110(2):182-96.
Massmann A, Rodt T, Marquardt S, Seidel R, Thomas K, Wacker F, et al. Transarterial chemoembolization (TACE) for colorectal liver metastases-current status and critical review. Langenbecks Arch Surg. 2015; 400:641-59.
Kallini JR, Gabr A, Abouchaleh N, Ali R, Riaz A, Lewandowski RJ, et al. New developments in interventional oncology. Liver metastasis from colorectal cancer. Cancer J. 2016; 22(6):373-80.
Vogl TJ, Lahrsow M, Albrecht MH, Hammerstingl R, Thompson ZM, Gruber-Rouh T. Survival of patients with non-resectabl, chemo therapy-resistant colorectal cancer liver metastases undergoing conventional lipiodol based transarterial chemoembolization (cTACE) palliatively versus neoadjuvantly prior to percutaneous thermal ablation. Eur J Radiol. 2018;102:138-45
Malagari K, Iezzi R, Goldberg N, Bilbao JJ, Sami A, Akhan O, et al. The ten commandments of chemoembolization: expert discussion and report from MIOLive congress 2017. Eur Rev Med Pharmacol Sci. 2018;22:372-81.
Lencioni R, Aliberti C, de Baere T, GarciaMonaco R, Narayanan G, O’Grady E, et al. Transartrial treatment of colorectal cancer liver metastases with irinotecan-loaded drug eluting beads: technical recommendations. J Vasc Interv Radiol. 2014;25(3):365-9.
Iezzi R, Marsico VA, Guerra A, Cerchiaro E, Cassano A, Basso M, et al. Trans-arterial chemoembolization with irinotecan-loaded drug-eluting beads (DEBIRI) and capecitabine in refractory liver prevalent colorectal metastases:a phase II single-center study. Cardiovasc Interv Radiol. 2015;38(6):1523-31.
Akinwande OK, Philips P, Duras P, Pluntke S, Scoggins C, Martin RCG. Small versus largesized drug-eluting beads (DEBIRI) for the treatment of hepatic colorectal metastases: a propensity score matching analysis. Cardiovasc Intervent Radiol. 2015;38(2):361-71.
Fereydooni A, Letzen B, Ghani MA, Miszczuk MA, Huber S, Chapiro J, et al. Irinotecan-Eluting 75-150-µm Embolics Lobar Chemoembolization in Patients with Colorectal Cancer Liver Metastases: A Prospective Single-Center Phase I Study. J Vasc Interv Radiol. 2018; 29(12):1646-53.
