Interventional radiology in the treatment of liver cancer

Abstract

Hepatocelularni karcinom (HCC) jedan je od najčešćih karcinoma u čovjeka. Rizični čimbenici kao što su ciroza jetre, virusi hepatitisa B i C (HBV i HCV), aflatoksin pridonose nastanku HCC-a. Osnovni simptom bolesti je bol u trbuhu. Ostali simptomi su umor, žutica, gubitak tjelesne mase, mučnina, povraćanje te oteknuće abdomena. Radiofrekventna ablacija (RFA), transarterijska kemoembolizacija (TACE), krioablacija, i perkutana injekcija etanola (PEI) važne su tehnike intervencijske radiologije koje se koriste u liječenju karcinoma jetre. Radiofrekventna ablacija (RFA) koristi električnu energiju za zagrijavanje i uništavanje stanica karcinoma. Značajnu primjenu ima u liječenju metastaza u jetri. Najozbiljnija komplikacija radiofrekventne ablacije jest zatajenje jetre. Cilj transarterijske kemoembolizacije (TACE) jest embolizirati tumor, te smanjiti dotok krvi u stanice karcinoma i isporučiti lijekove za kemoterapiju u te iste stanice. Koristi se kod pacijenata s intermedijarnim stadijem HCC-a. Krioablacija koristi ekstremnu hladnoću za uništavanje karcinomskih stanica. Komplikacije su relativno rijetke. Koristi se većinom kod bolesnika sa uznapredovalim stadijem HCC-a i metastazama. Perkutana injekcija etanola (PEI) koristi se kod bolesnika s ranim stadijem HCC-a. Prednosti ove metode su minimalna invazivnost, jednostavnost i niska cijena.Hepatocellular carcinoma (HCC) is one of the most common cancers in men. Risk factors such as cirrhosis, hepatitis B and C (HBV and HCV), aflatoxin contribute to the formation of HCC. The main symptom is abdominal pain. Other symptoms include fatigue, jaundice, weight loss, nausea, vomiting and abdominal swelling. Radiofrequency ablation (RFA), transarterial chemoembolization (TACE), cryoablation, and percutaneous ethanol injection (PEI) are important interventional techniques that are used in the treatment of liver cancer. Radiofrequency ablation (RFA) uses electricity to heat and destroy cancer cells. It has a significant application in the treatment of liver metastases. The most serious complication of radiofrequency ablation is liver failure. The aim of transarterial chemoembolization (TACE) is to metabolize tumor and reduce blood flow to the cancer cells as well as to deliver chemotherapeutic drugs to these cells. It is used in patients with intermediate stage HCC. Cryoablation uses extreme cold to destroy cancer cells. Complications are relatively rare. It is used mostly in patients with advanced stage HCC and metastases. Percutaneous ethanol injection (PEI) is used in patients with early stage HCC. The advantages of this method are minimal invasiveness, simplicity and low cost