Interventional Oncology

Abstract

• Over the course of the last century, cancer treatment evolved to a complex multimodality care pathway delivered by a multidisciplinary team including radiology, surgical, medical oncology and radiation oncology specialists.

• There is a continuous drive towards cure or control of cancer via minimally invasive techniques, reducing patient morbidity and improving quality of life.

• Interventional Radiologists have developed endovascular and percutaneous techniques for locoregional cancer treatment.

• This has become known as the fourth pillar of cancer care.

• Interventional oncology (IO) is a rapidly evolving specialty with frequent development and innovation, both in terms of interventional techniques and in the scope of cancer treatment.

• Once thought limited to salvage therapy and palliation, ablative and embolisation therapy is approaching equivalence to standard first line surgical care for certain tumours.

• Given the significant difference in morbidity and hospital stay, it is expected that IO techniques may supersede surgery for appropriate tumours in time.

• Patient care encompasses pre-procedure consultation and decision-making, admission and treatment, and follow-up imaging and care.

• The interventional oncologist is a clinician familiar with the key facets of cancer care and is trained to diagnose and manage the side-effects and complications of their procedures.

• IO is broadly divided into endovascular therapy and percutaneous ablation.

• Endovascular therapies involve access via the arterial system into the arteries suppling the tumour and direct delivery of chemotherapy and/or embolic material.

• Ablative techniques involve direct thermal or chemical destruction of the tumour via percutaneous delivery of an ablative device under image guidance.

• The principles of these techniques will be discussed, followed by examples of current clinical practice.