surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2017-7-1-57-62surgonco-214Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWРЕНТГЕНОЭНДОВАСКУЛЯРНАЯ ХИМИОЭМБОЛИЗАЦИЯ ПЕЧЕНОЧНОЙ АРТЕРИИ - СОВРЕМЕННЫЙ МЕТОД РЕГИОНАЛЬНОЙ ХИМИОТЕРАПИИ ЗЛОКАЧЕСТВЕННЫХ ПОРАЖЕНИЙ ПЕЧЕНИENDOVASCULAR CHEMOEMBOLIZATION OF THE HEPATIC ARTERY - A MODERN METHOD OF LOCAL CHEMOTHERAPY OF MALIGNANT LIVER LESIONSСерегинА. А.ZagaynovV. E.

зав. отделением рентгенохирургических методов диагностики и лечения,

Нижний Новгород

Chair of Surgery Department in the Faculty of Foreign Students Education;

Candidate of Medical Sciences, Chief Surgery Specialist,

Nizhniy Novgorod

ЗайцевА. И.SharabrinE. G.

врач рентгенохирургического отделения клинической больницы № 1,

 

Doctor of Medical Sciences, Director of Research and Education Institution of Applied and Fundamental Medicine,

Nizhniy Novgorod

ЗагайновЕ. М.ZagaynovE. M.

врач рентгенохирургического отделения клинической больницы № 1,

 

Physician at the X-ray Surgical Department of Clinical Hospital №1,

Nizhniy Novgorod

ШарабринЕ. Г.ZaytsevA. A.

д.м.н., директор НИИ ПФМ,

Нижний Новгород

Physician at the X-ray Surgical Department of Clinical Hospital №1,

Nizhniy Novgorod

sharabrin@hotbox.ruЗагайновВ. Е.SereginA. A.

к.м.н., главный специалист по хирургии Приволжского окружного медицинского центра ФМБА России;

зав. кафедрой хирургии ФОИС,

Нижний Новгород

Head at the X-ray Surgical Methods of Diagnostics and Treatment Department,

Nizhniy Novgorod

Приволжский окружной медицинский центр Федерального медико-биологического агентства РоссииРоссияNizhniy Novgorod State Medical Academy; Privolzhskiy Regional Medical Centre Federal Medical-Biological Agency of RussiaRussian FederationПриволжский окружной медицинский центр Федерального медико-биологического агентства РоссииРоссияNizhniy Novgorod State Medical AcademyRussian FederationПриволжский окружной медицинский центр Федерального медико-биологического агентства РоссииРоссияPrivolzhskiy Regional Medical Centre Federal Medical-Biological Agency of RussiaRussian FederationНижегородская государственная медицинская академияРоссияPrivolzhskiy Regional Medical Centre Federal Medical-Biological Agency of RussiaRussian FederationНижегородская государственная медицинская академия; Приволжский окружной медицинский центр Федерального медико-биологического агентства РоссииРоссияPrivolzhskiy Regional Medical Centre Federal Medical-Biological Agency of RussiaRussian Federation201724042017715762Copyright © Серегин А.А., Зайцев А.И., Загайнов Е.М., Шарабрин Е.Г., Загайнов В.Е., 20172017Серегин А.А., Зайцев А.И., Загайнов Е.М., Шарабрин Е.Г., Загайнов В.Е.Zagaynov V.E., Sharabrin E.G., Zagaynov E.M., Zaytsev A.A., Seregin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/214

Работа представляет собой обзор литературы, посвященный одной из важнейших тем современной онкологии - лечение больных злокачественными опухолями печени. Акцент в работе сделан на анализе изучения современных рентгеноэндоваскулярных методов лечения - рассматривается транскатетерная химиоэмболизация печеночной артерии. Описаны морфо-функциональные основы химиоэмболизации, приведено сравнение химиоэмболизационных препаратов, показаны результаты лечения. Сделан вывод об эффективности, позволяющей достичь положительной диопухоли печени, печеночная артерия, рентгеноэндоваскулярные методы лечения, транскатетерная химиоэмболизация, химиоэмболизация, обзор литературынамики и стабилизации процесса.

The paper deals with the review of literature devoted to one of the most important issues of contemporary oncology: treatment of malignant liver tumors. Much attention is paid to the analysis of modern endovascular treatment methods research, namely – transcatheter chemoembolization of the hepatic artery. The morphological and functional bases of chemoembolization are described in detail. The comparison between chemoembolization drugs are noted in the article, too. The results of research are shown. The conclusions about the efficiency that allows achieving positive dynamics and stabilization of the process are drawn.

опухоли печенипеченочная артериярентгеноэндоваскулярные методы лечениятранскатетерная химиоэмболизацияхимиоэмболизацияобзор литературыliver tumorshepatic arteryx-ray endovascular methods of treatmenttranscatheter chemoembolizationchemoembolizationreview of literatureReferencesГарин АМ, Базин ИС. Десять наиболее распространенных злокачественных опухолей. М.:КМК;2006.Гарин АМ, Базин ИС. Десять наиболее распространенных злокачественных опухолей. М.:КМК;2006.Базин ИС. Гепатоцеллюлярный рак - современное состояние проблемы. Практическая онкология. 2008;9(4):216-228.Базин ИС. Гепатоцеллюлярный рак - современное состояние проблемы. Практическая онкология. 2008;9(4):216-228.Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007;57(1):43-66. PMID: 17237035.Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007;57(1):43-66. PMID: 17237035.Eadens MJ, Grothey A. Curable metastatic colorectal cancer. Curr Oncol Rep. 2011;13(3):168-76. DOI: 10.1007/s11912-011-0157-0.Eadens MJ, Grothey A. Curable metastatic colorectal cancer. Curr Oncol Rep. 2011;13(3):168-76. DOI: 10.1007/s11912-011-0157-0.Патютко ЮИ. Хирургическое лечение злокачественных опухолей печени. М.:Практическая медицина;2005:234 с.Патютко ЮИ. Хирургическое лечение злокачественных опухолей печени. М.:Практическая медицина;2005:234 с.Патютко ЮИ, Сагайдак ИВ, Котельников АГ, и др. Хирургическое и комбинированное лечение метастазов колоректального рака в печень. Вестник московского онкологического общества. М.: 2004;9-13.Патютко ЮИ, Сагайдак ИВ, Котельников АГ, и др. Хирургическое и комбинированное лечение метастазов колоректального рака в печень. Вестник московского онкологического общества. М.: 2004;9-13.Алентьев СА, Котив БН, Дзидзава ИИ. Хирургическое лечение больных с метастазами колоректального рака в печень с применением химиотерапии. Анналы хирургической гепатологии. 2010;15(4):9-18. [Alientyev SA, Kotiv BN, Dzidzava II, Lazutkin MV, Molchanov AA. Chemotherapy in surgical treatment chemotherapy in surgical treatment of the colorectal cancer liver metastases of the colorectal cancer liver metastases. Annaly khirurgicheskoy gepatologii. 2010;15(4):9-18. (in Russ.)]Алентьев СА, Котив БН, Дзидзава ИИ. Хирургическое лечение больных с метастазами колоректального рака в печень с применением химиотерапии. Анналы хирургической гепатологии. 2010;15(4):9-18. [Alientyev SA, Kotiv BN, Dzidzava II, Lazutkin MV, Molchanov AA. Chemotherapy in surgical treatment chemotherapy in surgical treatment of the colorectal cancer liver metastases of the colorectal cancer liver metastases. Annaly khirurgicheskoy gepatologii. 2010;15(4):9-18. (in Russ.)]Benoist S, Nordlinger B. The role of preoperative chemotherapy in patients with resectable colorectal liver metastases. Ann Surg Oncol. 2009;16(9): 2385-2390. DOI: 10.1245/s10434-009-0492-7.Benoist S, Nordlinger B. The role of preoperative chemotherapy in patients with resectable colorectal liver metastases. Ann Surg Oncol. 2009;16(9): 2385-2390. DOI: 10.1245/s10434-009-0492-7.Rahbari NN, Mehrabi A, Mollberg NM, Müller SA, Koch M, Büchler MW, et al. Hepatocellular carcinoma: current management and perspectives for the future. Ann Surg. 2011;253(3):453-69. DOI: 10.1097/SLA.0b013e31820d944f.Rahbari NN, Mehrabi A, Mollberg NM, Müller SA, Koch M, Büchler MW, et al. Hepatocellular carcinoma: current management and perspectives for the future. Ann Surg. 2011;253(3):453-69. DOI: 10.1097/SLA.0b013e31820d944f.Долгушин БИ, Виршке ЭР, Кучинский ГА, Рощин ЕМ, Трофимов ИА. Рентгеноэндоваскулярное лечение больных неоперабельным гепатоцеллюлярным раком. Анналы хирургической гепатологии. 2010;15(4):18-24. [Dolgushin BI, Virshke ER, Kuchinski GA, Roshchin EM, Trofimov IA. Radioendovascular management radioendovascular management of unoperable hepatocellular carcinoma patients of unoperable hepatocellular carcinoma patients. Annaly khirurgicheskoy gepatologii. 2010;15(4):18-24 (in Russ.)].Долгушин БИ, Виршке ЭР, Кучинский ГА, Рощин ЕМ, Трофимов ИА. Рентгеноэндоваскулярное лечение больных неоперабельным гепатоцеллюлярным раком. Анналы хирургической гепатологии. 2010;15(4):18-24. [Dolgushin BI, Virshke ER, Kuchinski GA, Roshchin EM, Trofimov IA. Radioendovascular management radioendovascular management of unoperable hepatocellular carcinoma patients of unoperable hepatocellular carcinoma patients. Annaly khirurgicheskoy gepatologii. 2010;15(4):18-24 (in Russ.)].Yamada R, Nakatsuka H, Nakamura K, Sato M, Tamaoka K, Takemoto K, et al. Super-selective arterial embolization in unresectable hepatomas. Nihon Igaku Hoshasen Gakkai Zasshi. 1979;39(5):540-543. PMID: 90362.Yamada R, Nakatsuka H, Nakamura K, Sato M, Tamaoka K, Takemoto K, et al. Super-selective arterial embolization in unresectable hepatomas. Nihon Igaku Hoshasen Gakkai Zasshi. 1979;39(5):540-543. PMID: 90362.Yamada R, Nakamura K. Transcatheter arterial embolization therapy. Nihon Rinsho. 1982;40(1):183-90. PMID: 6283203.Yamada R, Nakamura K. Transcatheter arterial embolization therapy. Nihon Rinsho. 1982;40(1):183-90. PMID: 6283203.Konno T, Maeda H, Yokoyama I, Iwai K, Ogata K, Tashiro S, et al. Use of a lipid lymphographic agent, lipiodol, as a carrier of high molecular weight antitumor agent, smancs, for hepatocellular carcinoma. Gan To Kagaku Ryoho. 1982;9(11):2005-15. PMID: 6307179.Konno T, Maeda H, Yokoyama I, Iwai K, Ogata K, Tashiro S, et al. Use of a lipid lymphographic agent, lipiodol, as a carrier of high molecular weight antitumor agent, smancs, for hepatocellular carcinoma. Gan To Kagaku Ryoho. 1982;9(11):2005-15. PMID: 6307179.Konno T, Tashiro S, Maeda H, Iwai K, Ogata K, Mochinaga M, et al. Intra-arterial injection of an oily antineoplastic agent in hepatic cancer. Gan To Kagaku Ryoho. 1983;10(2): 351-7. PMID: 6309086.Konno T, Tashiro S, Maeda H, Iwai K, Ogata K, Mochinaga M, et al. Intra-arterial injection of an oily antineoplastic agent in hepatic cancer. Gan To Kagaku Ryoho. 1983;10(2): 351-7. PMID: 6309086.Regensberg C, Richard JP, Doyon D, Frileux C. May hepatic artery embolization replace surgical desarterialization in hepatic tumors? Nouv Presse Med. 1973;2(25):1717-1718. PMID: 4718543.Regensberg C, Richard JP, Doyon D, Frileux C. May hepatic artery embolization replace surgical desarterialization in hepatic tumors? Nouv Presse Med. 1973;2(25):1717-1718. PMID: 4718543.Marelli L, Stigliano R, Triantos C, Senzolo M, Cholongitas E, Davies N, et al. Transarterial therapy for hepatocellular carcinoma: Which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol. 2007;30(1):6-25. DOI: 10.1007/s00270-006-0062-3.Marelli L, Stigliano R, Triantos C, Senzolo M, Cholongitas E, Davies N, et al. Transarterial therapy for hepatocellular carcinoma: Which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol. 2007;30(1):6-25. DOI: 10.1007/s00270-006-0062-3.Гранов АМ, Давыдов МИ. (ред.) Интервенционная радиология в онкологии. Пути развития и технологии: научно-практическое издание. СПб: Фолиант; 2007:342.Гранов АМ, Давыдов МИ. (ред.) Интервенционная радиология в онкологии. Пути развития и технологии: научно-практическое издание. СПб: Фолиант; 2007:342.Doros A. Interventional radiological treatment of hepatocellular carcinoma. Cancer Control. 2010;17(2):87-99. PMID: 20404792.Doros A. Interventional radiological treatment of hepatocellular carcinoma. Cancer Control. 2010;17(2):87-99. PMID: 20404792.Таразов ПГ. Рентгеноэндоваскулярные вмешательства в лечении первичного рака печени. Практическая онкология. 2008;9(4):210-215.Таразов ПГ. Рентгеноэндоваскулярные вмешательства в лечении первичного рака печени. Практическая онкология. 2008;9(4):210-215.Okabe K, Beppu T, Haraoka K, Oh-Uchida Y, Yamamura S, Tomiyasu S, et al. Safety and shortterm therapeutic effects of miriplatin-lipiodol suspension in transarterial chemoembolization (TACE) for hepatocellular carcinoma. Anticancer Res. 2011;31(9):2983-2988. PMID: 21868548.Okabe K, Beppu T, Haraoka K, Oh-Uchida Y, Yamamura S, Tomiyasu S, et al. Safety and shortterm therapeutic effects of miriplatin-lipiodol suspension in transarterial chemoembolization (TACE) for hepatocellular carcinoma. Anticancer Res. 2011;31(9):2983-2988. PMID: 21868548.Sangro B, D’Avola D, I arrairaegui M, Prieto J. Transarterial therapies for hepatocellular carcinoma. Expert Opin Pharmacother. 2011;12(7):1057-73. DOI: 10.1517/14656566.2011.545346.Sangro B, D’Avola D, I arrairaegui M, Prieto J. Transarterial therapies for hepatocellular carcinoma. Expert Opin Pharmacother. 2011;12(7):1057-73. DOI: 10.1517/14656566.2011.545346.Varela M, Real MI, Burrel M, Forner A, Sala M, Brunet M, et al. Chemoembolization of hepatoceilular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol. 2007;46(3):474-481. DOI: 10.1016/j.jhep.2006.10.020.Varela M, Real MI, Burrel M, Forner A, Sala M, Brunet M, et al. Chemoembolization of hepatoceilular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol. 2007;46(3):474-481. DOI: 10.1016/j.jhep.2006.10.020.Jordan O, Denys A, De Baere T, Boulens N, Doelker E. Comparative study of chemoembolization loadable beads: in vitro drug release and physical properties of DC bead and hepasphere loaded with doxorubicin and irinotecan. J Vasc Interv Radiol. 2010;21(7):1084-1090. DOI: 10.1016/j.jvir.2010.02.042.Jordan O, Denys A, De Baere T, Boulens N, Doelker E. Comparative study of chemoembolization loadable beads: in vitro drug release and physical properties of DC bead and hepasphere loaded with doxorubicin and irinotecan. J Vasc Interv Radiol. 2010;21(7):1084-1090. DOI: 10.1016/j.jvir.2010.02.042.Grosso M, Vignali C, Quaretti P, Nicolini A, Melchiorre F, Gallarato G, et al. Transarterial chemoembolization for hepatoceilular carcinoma with drug-eluting microspheres: preliminary results from an Italian multicentre study. Cardiovasc Intervent Radiol. 2008;31(6):1141-9. DOI: 10.1007/s00270-008-9409-2.Grosso M, Vignali C, Quaretti P, Nicolini A, Melchiorre F, Gallarato G, et al. Transarterial chemoembolization for hepatoceilular carcinoma with drug-eluting microspheres: preliminary results from an Italian multicentre study. Cardiovasc Intervent Radiol. 2008;31(6):1141-9. DOI: 10.1007/s00270-008-9409-2.Liapi E, Geschwind JF. Chemoembolization for primary and metastatic liver cancer. Cancer J. 2010;16(2):156-62. DOI: 10.1097/PPO.0b013e3181d7e905.Liapi E, Geschwind JF. Chemoembolization for primary and metastatic liver cancer. Cancer J. 2010;16(2):156-62. DOI: 10.1097/PPO.0b013e3181d7e905.Lammer J, Malagari K, Vogl T, Pilleul F, Denys A, Watkinson A, et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol. 2010;33(1):41-52. DOI: 10.1007/s00270-009-9711-7.Lammer J, Malagari K, Vogl T, Pilleul F, Denys A, Watkinson A, et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol. 2010;33(1):41-52. DOI: 10.1007/s00270-009-9711-7.Liapi E, Geschwind JH. Transcatheter arterial chemoembolization for liver cancer: is it time to distinguish conventional from drug-eluting chemoembolization? Cardiovasc Intervent Radiol. 2011;34(1):37-49. DOI: 10.1007/s00270-010-0012-y.Liapi E, Geschwind JH. Transcatheter arterial chemoembolization for liver cancer: is it time to distinguish conventional from drug-eluting chemoembolization? Cardiovasc Intervent Radiol. 2011;34(1):37-49. DOI: 10.1007/s00270-010-0012-y.Frilling A, Sotiropoulos GC, Li J, Kornasiewicz1 O, Pl ckinger U. Multimodal management of neuroendocrine liver metastases. HPB (Oxford). 2010;12(6):361-79. DOI: 10.1111/j.1477-2574.2010.00175.x.Frilling A, Sotiropoulos GC, Li J, Kornasiewicz1 O, Pl ckinger U. Multimodal management of neuroendocrine liver metastases. HPB (Oxford). 2010;12(6):361-79. DOI: 10.1111/j.1477-2574.2010.00175.x.Georgiades CS, Hong K, D’Angelo M, Geschwind JF. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol. 2005;16(12):1653-9. DOI: 10.1097/01.RVI.0000182185.47500.7AGeorgiades CS, Hong K, D’Angelo M, Geschwind JF. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol. 2005;16(12):1653-9. DOI: 10.1097/01.RVI.0000182185.47500.7AGates J, Hartnell GG, Stuart KE, Clouse ME. Chemoembolization of hepatic neoplasms: safety, complications, and when to worry. Radiographics. 1999;19(2):399-414. DOI: 10.1148/radiographics.19.2.g99mr08399.Gates J, Hartnell GG, Stuart KE, Clouse ME. Chemoembolization of hepatic neoplasms: safety, complications, and when to worry. Radiographics. 1999;19(2):399-414. DOI: 10.1148/radiographics.19.2.g99mr08399.Martin RC, Rustein L, P rez Enguix D, Palmero J, Carvalheiro V, Urbano J, et al. Hepatic arterial infusion of doxorubicin-loaded microsphere for treatment of hepatocellular cancer: a multi-institutional registry. J Am Coll Surg. 2011; 213(4):493-500. DOI: 10.1016/j.jamcollsurg.2011.07.010.Martin RC, Rustein L, P rez Enguix D, Palmero J, Carvalheiro V, Urbano J, et al. Hepatic arterial infusion of doxorubicin-loaded microsphere for treatment of hepatocellular cancer: a multi-institutional registry. J Am Coll Surg. 2011; 213(4):493-500. DOI: 10.1016/j.jamcollsurg.2011.07.010.Takayasu K, Arii S, Ikai I, Omata M, Okita K, Ichida T, et al Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology. 2006;131(2):461-9. DOI: 10.1053/j.gastro.2006.05.021.Takayasu K, Arii S, Ikai I, Omata M, Okita K, Ichida T, et al Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology. 2006;131(2):461-9. DOI: 10.1053/j.gastro.2006.05.021.Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205-16. PMID: 10655437.Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205-16. PMID: 10655437.Poggi G, Pozzi E, Riccardi A, Tonini S, Montagna B, Quaretti P, et al. Complications of image-guided transcatheter hepatic chemoembolization of primary and secondary tumours of the liver. Anticancer Res. 2010; 30(12):5159-64. PMID: 21187505.Poggi G, Pozzi E, Riccardi A, Tonini S, Montagna B, Quaretti P, et al. Complications of image-guided transcatheter hepatic chemoembolization of primary and secondary tumours of the liver. Anticancer Res. 2010; 30(12):5159-64. PMID: 21187505.Russell JS, Sawhney R, Monto A, Nanavati S, Davoren JB, Aslam R, et al. Periprocedural complications by Child-Pugh class in patients undergoing transcatheter arterial embolization or chemoembolization to treat unresectable hepatocellular carcinoma at al. VA medical center. Am J Surg. 2010;200 (5):659-664. DOI: 10.1016/j.amjsurg.2010.07.021.Russell JS, Sawhney R, Monto A, Nanavati S, Davoren JB, Aslam R, et al. Periprocedural complications by Child-Pugh class in patients undergoing transcatheter arterial embolization or chemoembolization to treat unresectable hepatocellular carcinoma at al. VA medical center. Am J Surg. 2010;200 (5):659-664. DOI: 10.1016/j.amjsurg.2010.07.021.Martin RC, Joshi J, Robbins K, Tomalty D, O’Hara R, Tatum C. Transarterial Chemoembolization of Metastatic Colorectal Carcinoma with Drug-Eluting Beads, Irinotecan (DEBIRI): Multi-Institutional Registry. J Oncol. 2009; 5(3): 97-95. DOI: 10.1155/2009/539795. Epub 2009 Oct 29.Martin RC, Joshi J, Robbins K, Tomalty D, O’Hara R, Tatum C. Transarterial Chemoembolization of Metastatic Colorectal Carcinoma with Drug-Eluting Beads, Irinotecan (DEBIRI): Multi-Institutional Registry. J Oncol. 2009; 5(3): 97-95. DOI: 10.1155/2009/539795. Epub 2009 Oct 29.

The authors declare that there are no conflicts of interest present.