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Transarterielle perkutane Chemoembolisation beim Leberzellkarzinom

Transarterial chemoembolisation in hepatocellular carcinoma

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Zusammenfassung

Das hepatozelluläre Karzinom stellt in der westlichen Welt eines der häufigsten tumorbedingten Todesursachen dar. Der vorliegende Artikel befasst sich mit der transarteriellen Chemoembolisation (TACE) als palliative Behandlungsmethode.

Die TACE verfolgt 2 verschiedene therapeutische Ansätze. Es wird kombiniert eine lokale Chemotherapie über die das HCC versorgende Arterie appliziert und anschließend eine Devaskularisation des Tumors durch ein selektives Verschließen der zuführenden Arterie durchgeführt. Verschiedene Embolisationstechniken und Zytostatika werden beschrieben. Die TACE stellt eine sichere und gering invasive Therapiemaßnahme dar. Die häufigste Nebenwirkung stellt das Postembolisationssyndrom dar mit den klinischen Symptomen Übelkeit, Erbrechen, Fieber und Bauchschmerzen bis hin zu einem sehr selten auftretendem Leberversagen.

Das Therapieziel ist die Progression der Tumorerkrankung zu unterbinden, das progressionsfreie Intervall zu verlängern und die Lebensqualität zu erhalten. Weitere Therapieindikationen stellen das Überbrücken des Zeitraumes bis zur Lebertransplantation und das Konzept der neoadjuvanten Behandlung dar.

Die TACE gilt daher als eine wichtige Behandlungsoption des HCC. Die Therapieindikation sollte jedoch individuell durch ein interdisziplinäres Tumorboard gestellt werden.

Summary

Hepatocellular carcinoma is one of the most common cause of cancer related death. The present review gives an overview on the loco-regional therapy performed by transarterial chemoembolization (TACE).

TACE combines two different therapeutic approaches. First, application of chemotherapeutic agents into tumor’s feeding vessels and second, selectively de-arterialization by different particle embolization applicated during angiography. Different chemoembolization agents and techniques are described. The methode is save and less invasive. Side effects range from the postembolization syndrom with nausea, vomiting, fever and abdominal pain up to hepatic insufficiency, which is very rare.

The aim of the therapy is control clinical symptoms, prolonge progression free survival, stabilize quality of life and survival. Further indications are bridging therapy prior liver transplantation and TACE is used as a neoadjuvant therapy.

Thus, TACE plays a role in the therapy of HCC and indication should be tailored to the individual patient’s condition by an interdisciplinary tumor board.

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  1. Department Radiologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich

    Johannes Petersen, Benjamin Henninger, Bernhard Glodny & Werner Jaschke

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  1. Johannes Petersen
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Correspondence to Johannes Petersen.

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Petersen, J., Henninger, B., Glodny, B. et al. Transarterielle perkutane Chemoembolisation beim Leberzellkarzinom. Wien Med Wochenschr 163, 123–127 (2013). https://doi.org/10.1007/s10354-013-0180-x

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