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Transvaskuläre Therapie des hepatozellulären Karzinoms

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Angiofibel

Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist weltweit betrachtet das fünfthäufigste Malignom bei steigender Inzidenz. In mehr als 80 % der Fälle ist es die Folge einer Leberzirrhose und inzwischen die Haupttodesursache bei Patienten mit dieser Erkrankung in Europa. Da kurative Therapieansätze (Resektion, Lebertransplantation sowie intraoperative/perkutane Radiofrequenz- oder Mikrowellenablation) bei nur 30–40 % der HCC‑Patienten in Frage kommen, sind oft lokalbegrenzte und palliative Therapieansätze notwendig.

In den letzten Dekaden waren die Fortschritte bei solchen minimal-invasiven Verfahren wie der transarteriellen Chemoembolisation (TACE), der Radiofrequenzablation (RFA) und Mikrowellenablation (MWA) oder der Radioembolisation mit Yttrium‑90-Mikrosphären (selektive interne Radiotherapie, SIRT) enorm. Die TACE stellt mit ihren verschiedenen Therapieregimen beim HCC nach wie vor den Grundpfeiler der interventionellen Onkologie dar und erfolgt in palliativer Absicht bzw. einem kurativen Ansatz zum Downstaging oder als Überbrückungstherapie vor Lebertransplantation.

Häufig wird der Begriff TACE synonym für jede Form der Behandlung über das arterielle Tumorgefäßbett gebraucht. Tatsächlich handelt es sich bei den verschiedenen transvaskulären Behandlungen jedoch um sehr unterschiedliche Therapiestrategien. Diese können in fünf Hauptgruppen unterteilt werden:

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Authors and Affiliations

  1. Radiologische Klinik, Abteilung Diagnostische und Interventionelle Radiologie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Boris A. Radeleff Prof. Dr.

  2. Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Anne Schmitz Dr. med.

  3. Abteilung Radiologie, Klinik im Park, Seestraße 220, 8027, Zürich, Schweiz

    Waldemar Hosch PD Dr. med.

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  1. Boris A. Radeleff Prof. Dr.
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  2. Anne Schmitz Dr. med.
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  3. Waldemar Hosch PD Dr. med.
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Correspondence to Boris A. Radeleff Prof. Dr. .

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  1. Radiologische Klinik, Abteilung Diagnostische und Intervention, Universität Heidelberg, Im Neuenheimer Feld 110, Heidelberg, 69120, Baden-Württemberg, Germany

    Boris A. Radeleff

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Radeleff, B.A., Schmitz, A., Hosch, W. (2013). Transvaskuläre Therapie des hepatozellulären Karzinoms. In: Radeleff, B. (eds) Angiofibel. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-33230-2_13

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  • DOI: https://doi.org/10.1007/978-3-642-33230-2_13

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