Transcatheter Locoregional Therapies for Hepatocellular Carcinoma
Summary
Transcatheter locoregional therapies harness the unique vascular anatomy of the liver to deliver treatment directly to hepatocellular carcinoma (HCC) while sparing healthy parenchyma. By advancing microcatheters into tumour-feeding branches of the hepatic artery, clinicians can administer chemotherapeutic agents, embolic materials or radioactive particles to induce tumour necrosis through ischaemia, cytotoxicity and radiobiological effects. Conventional transcatheter arterial chemoembolization (TACE) employs oil-based mixtures and embolic particles, whereas drug-eluting bead TACE (D-TACE) achieves sustained local drug release. Additional modalities include endovascular brachytherapy, in which iodine-125 seeds are deployed within vessels or tumour beds to provide continuous low-dose radiation, and combined thermal ablation techniques such as radiofrequency ablation (RFA). These approaches have become integral to management of intermediate-stage HCC, serve as bridging therapy prior to transplantation, and offer palliative benefit in advanced cases complicated by portal vein tumour thrombus (PVTT). Recent advances in image guidance, embolic formulations and integrated multimodal regimens have extended survival, improved local control and reduced systemic toxicity.
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Transcatheter Locoregional Therapies for Hepatocellular Carcinoma publication trend
The graph below shows the total number of articles in transcatheter locoregional therapies for hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).
Technical terms
Transcatheter arterial chemoembolization (TACE): Delivery of chemotherapeutic agents and embolic particles to a liver tumour via the hepatic artery to induce ischaemia and cytotoxicity.
Doxorubicin-eluting bead TACE (D-TACE): A form of TACE in which chemotherapy is released gradually from microspheres to prolong local drug exposure.
Endovascular brachytherapy: Implantation of radioactive material, such as iodine-125 seeds, within vessels or tumours to deliver targeted radiotherapy.
Radiofrequency ablation (RFA): Thermal destruction of tumour tissue using high-frequency alternating electric current delivered via a needle electrode.
Iodine-125 seed implantation: Placement of low-energy radioactive seeds in or near a tumour to provide continuous local radiation.
Portal vein tumour thrombus (PVTT): Obstruction of the portal vein by tumour emboli, often seen in advanced hepatocellular carcinoma and associated with poor prognosis.
References
- Evaluation of D-TACE combined with endovascular brachytherapy for HCC with MPVTT. Frontiers in Oncology (2022).
- Combined Ultrasound and CT-Guided Iodine-125 Seeds Implantation for Treatment of Residual Hepatocellular Carcinoma Located at Complex Sites After Transcatheter Arterial Chemoembolization. Frontiers in Oncology (2021).
- Combined image-guided radiofrequency and iodine-125 seeds implantation in the treatment of recurrent hepatocellular carcinoma after hepatectomy. BMC Cancer (2024).
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