Zusammenfassung
Maligne Neoplasien der Leber sind primär hepatisch oder sekundär metasta- tisch. In den westlichen Ländern überwiegen metastatische Läsionen, während in Asien und Subsahara-Afrika primäre Lebermalignome häufiger gefunden werden. Jährlich erkranken in den USA 50.000 Patienten neu an Lebermetastasen von kolorektalen Tumoren. Auch in unseren Breitengraden sind Metastasen mit 95–97% die häufigsten malignen Lebergeschwülste. Bei nahezu allen malignen Tumoren können im Laufe der Erkrankung Lebermetastasen auftreten. Obduktionen zeigten bei Tumorerkrankungen in bis zu 50 % der Fälle einen metastatischen Befall der Leber (Edmondson u. Peters 1987). Nach den Lymphknoten ist die Leber der häufigste Sitz von Metastasen. Der überwiegende Metastasierungsweg führt hämatogen über die V. portae (Pfortadertyp) oder die A. hepatica (Lebertyp).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Daniels JR, Sternlicht M, Daniels AM (1988) Collagen chemoembolization: Pharmacokinetics and tissue tolerance of cis-diamminedichloroplatinum(II) in porcine liver and rabbit kidney. Cancer Res 48: 2446–2450
Diamandidou E, Ajani JA, Yang DJ et al. (1998) Two-phase study of hepatic artery vascular occlusion with microencapsulated cisplatin in patients with liver metastases from neuroendocrine tumors. AJR Am J Roentgenol 170: 339–344
Dominguez S, Denys A, Madeira I et al. (2000) Hepatic arterial chemoembolization with streptozotocin in patients with metastatic digestive endocrine tumours. Gastroenterol Hepatol 12: 151–157
Edmondson HA, Peters RL (1987) Neoplasms of the liver. In: Schiff L, Schiff E (eds) Disease of the liver. Lippincott, Philadelphia, pp 1103–1158
Falconi M, Bassi C, Bonora A et al. (1999) Role of chemoembolization in synchronous liver metastases from pancreatic endocrine tumours. Dig Surg 16: 32–38
Feun LG, Reddy KR, Yrizarry JM et al. (1994) A phase I study of chemoembolization with cisplatin and lipiodol for primary and metastatic liver cancer. Am J Clin Oncol 17: 405–410
Grote R, Schmoll E, Dohring W, Rosenthal H, Reimer P, Dralle H (1990) Chemical embolization of carcinoid metastases in the liver. Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 153: 595–600
Henne T (1986) Pharmakokinetische und -dynamische Aspekte regionaler Chemotherapie speziell von Lebermetastasen colorectaler Carcinome. In: Hottentrott C, Nagel K, Lorenz M (Hrsg) Regionale Chemotherapie der Leber und Extremitäten, Standortbestimmung. Kehrer, Freiburg, S 32–38
Huppert PE, Geissler F, Duda SH et al. (1994) Chemoembolisation des hepatozellulären Karzinoms: Computertomographische Befunde und klinische Resultate bei prospektiver repetitiver Therapie. Fortschr Roentgenstr 160: 425–432
Inoue H, Kobayashi H, Itoh Y, Shinohara S (1989) Treatment of liver metastases by arterial injection of adriamycin/mitomycin C lipiodol suspension. Acta Radiol 30: 603–608
Kameyama M, Imaoka S, Fukuda I et al. (1993) Delayed washout of intratumor blood flow is associated with good response to intraarterial chemoembolization for liver metastasis of colorectal cancer. Surgery 114: 97–101
Kemeny N, Huang Y, Cohen AM et al. (1999) Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 341: 2039–2048
Kennedy KA, Rockwell S, Sartorelli AC (1980) Preferential activation of mitomycin C to cytotoxic metabolites by hypoxic tumor cells. Cancer Res 40: 2356–2360
Kobayashi H, Inoue H, Shimada J, Yano T, Maeda T, Oyama T, Shinohara S (1987) Intra-arterial injection of adriamycin/mitomycin C lipiodol suspension in liver metastases. Acta Radiol 28: 275–280
Lang EK, Brown CL Jr (1993) Colorectal metastases to the liver: Selective chemoembolization. Radiology 189: 417–422
Leichman CG, Jacobson JR, Modiano M et al. (1999) Hepatic chemoembolization combined with systemic infusion of 5-fluorouracil and bolus leucovorin for patients with metastatic colorectal carcinoma: A Southwest Oncology Group pilot trial. Cancer 86: 775–781
Lencioni R, Paolicchi A, Moretti M et al. (1998) Combined transcatheter arterial chemoembolization and percutaneous ethanol injection for the treatment of large hepatocellular carcinoma: Local therapeutic effect and long-term survival rate. Eur Radiol 8: 439–444
Mavligit GM, Charnsangavej C, Carrasco CH, Patt YZ, Benjamin RS, Wallace S (1988) Regression of ocular melanoma metastatic to the liver after hepatic arterial chemoembolization with cisplatin and polyvinyl sponge. JAMA 260: 974–976
Meakem TJD, Unger EC, Pond GD, Modiano MR, Alberts DR (1992) CT findings after hepatic chemoembolization. J Comput Assist Tomogr 16: 916–920
Pan SS, Andrews PA, Glover CJ, Bachur NR (1984) Reductive activation of mitomycin C and mitomycin C metabolites catalyzed by NADPH-cytochrome P-450 reductase and xanthine oxidase. J Biol Chem 259: 959–966
Patt YZ, Chuang VP, Wallace S, Hersh EM, Freireich EJ, Mavligit GM (1981) The palliative role of hepatic arterial infusion and arterial occlusion in colorectal carcinoma metastatic to the liver. Lancet 1: 349–350
Pentecost MJ, Daniels JR, Teitelbaum GP, Stanley P (1993) Hepatic chemoembolization: Safety with portal vein thrombosis. J Vase Interv Radiol 4: 347–351
Pirschel J, Lauchart W (1991) Chemoembolisation primärer Leberkarzinome mit Epirubicin-Lipiodol. Fortschr Roentgenstr 155: 409–415
Schlag PM, Benhidjeb T, Kilpert B (1999) Prinzipien der kurativen Lebermetastasenresektion. Chirurg 70: 123–132
Soulen MC (1994) Chemoembolization of hepatic malignancies. Oncology (Huntingt) 8: 77–84 (discussion 84, 89–90 passim)
Starkhammar H, Hakansson L, Morales O, Svedberg J (1987) Intra-arterial mitomycin C treatment of unresectable liver tumours. Preliminary results on the effect of degradable starch microspheres. Acta Oncol 26: 295–300
Steger W, Vogl TJ, Hosten N, Steger S, Hidajat N, Felix R (1998) Dopplersonographische Verlaufskontrolle der Perfusion hepatozellulärer Karzinome nach arterieller Chemoembolisation. Fortschr Roentgenstr 168: 49–56
Stokes KR, Stuart K, Clouse ME (1993) Hepatic arterial chemoembolization for metastatic endoerine tumors. J Vase Interv Radiol 4: 341–345
Taniguchi H, Takahashi T, Yamaguchi T, Sawai K (1989) Intraarterial infusion chemotherapy for metastatic liver tumors using multiple anti-cancer agents suspended in a lipid contrast medium. Cancer 64: 2001–2006
Tellez C, Benson AB 3rd, Lyster MT et al. (1998) Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature. Cancer 82: 1250–1259
Therasse E, Breittmayer F, Roche A et al. (1993) Transcatheter chemoembolization of progressive carcinoid liver metastasis. Radiology 189: 541–547
Vogl TJ, Mack MG, Straub R, Engelmann K, Zangos S, Eichler K (1999 a) Interventionelle MR-gesteuerte laserinduzierte Thermotherapie bei onkologischen Fragestellungen. Stand und Ausblick. Der Radiologe 39: 764–771
Vogl TJ, Muller PK, Mack MG, Straub R, Engelmann K, Neuhaus P (1999 b) Liver metastases: Interventional therapeutic techniques and results, State of the art. Eur Radiol 9: 675–684
Vogl TJ, Schroeder H, Trapp M et al. (2000a) Mulitsequentielle arterielle Chemoembolisation fortgeschrittener hepatozellulärer Karzinome: Computertomographische Verlaufsparameter zur Beurteilung des Ansprechens auf die Therapie. Fortschr Roentgenstr 172: 43–50
Vogl TJ, Trapp M, Schroeder H et al. (2000b) Transarterial chemoembolization for hepatocellular carcinoma: Volumetrie and morphologic CT criteria for assessment of prognosis and therapeutic success-results from a liver transplantation center. Radiology 214: 349–357
Wollner IS, Walker-Andrews SC, Smith JE, Ensminger WD (1986) Phase II study of hepatic arterial degradable starch microspheres and mitomycin. Cancer Drug Deliv 3: 279–284
Yamashita Y, Takahashi M, Bussaka H, Fukushima S, Kawaguchi T, Nakano M(1989) Intraarterial infusion of 5-fluoro-2-deoxyuridine-C8 dissolved in a lymphographic agent in malignant liver tumors. A preliminary report. Cancer 64: 2437–2444
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Zangos, S. et al. (2002). Transarterielle Chemoembolisation (TACE) bei sekundären Lebertumoren. In: Vogl, T.J., Mack, M.G., Balzer, J.O. (eds) LeberMetastasen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59385-7_24
Download citation
DOI: https://doi.org/10.1007/978-3-642-59385-7_24
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-63958-6
Online ISBN: 978-3-642-59385-7
eBook Packages: Springer Book Archive