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DOI: 10.1055/s-0039-1694784
Interventional Oncology for Hepatic Malignancy in Children
Publication History
21 March 2019
13 June 2019
Publication Date:
27 August 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00032260/201903/lookinside/thumbnails/10-1055-s-0039-1694784_1900014-1.jpg)
Abstract
The field of interventional radiology has become an integral contributor in the multidisciplinary oncological treatment of numerous solid tumors in the adult population, especially hepatic malignancies. With continued growth and sophistication in the field of pediatric interventional radiology, interventional oncology (IO) principles and techniques are increasingly applied to children. While primary pediatric hepatic malignancies are less frequent than in the adult population, application of these IO principles and modalities in adults is becoming more commonplace. This article reviews the increasing application of these IO principles and modalities for the treatment of primary pediatric hepatic malignancy, as well as their role in the multidisciplinary care of children afflicted with these diseases.
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References
- 1 Meyers RL. Tumors of the liver in children. Surg Oncol 2007; 16 (03) 195-203
- 2 Allan BJ, Wang B, Davis JS. , et al. A review of 218 pediatric cases of hepatocellular carcinoma. J Pediatr Surg 2014; 49 (01) 166-171 , discussion 171
- 3 Ismail H, Broniszczak D, Kaliciński P. , et al. Liver transplantation in children with hepatocellular carcinoma. Do Milan criteria apply to pediatric patients?. Pediatr Transplant 2009; 13 (06) 682-692
- 4 Lungren MP, Towbin AJ, Roebuck DJ. , et al. Role of interventional radiology in managing pediatric liver tumors : part 1: endovascular interventions. Pediatr Radiol 2018; 48 (04) 555-564
- 5 Aronson DC, Meyers RL. Malignant tumors of the liver in children. Semin Pediatr Surg 2016; 25 (05) 265-275
- 6 Czauderna P, Haeberle B, Hiyama E. , et al. The Children's Hepatic tumors International Collaboration (CHIC): novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model. Eur J Cancer 2016; 52: 92-101
- 7 Czauderna P, Lopez-Terrada D, Hiyama E, Häberle B, Malogolowkin MH, Meyers RL. Hepatoblastoma state of the art: pathology, genetics, risk stratification, and chemotherapy. Curr Opin Pediatr 2014; 26 (01) 19-28
- 8 Wang J, Mao Y, Liu Y. , et al. Hepatocellular carcinoma in children and adolescents: clinical characteristics and treatment. J Gastrointest Surg 2017; 21 (07) 1128-1135
- 9 López-Terrada D, Alaggio R, de Dávila MT. , et al; Children's Oncology Group Liver Tumor Committee. Towards an international pediatric liver tumor consensus classification: proceedings of the Los Angeles COG liver tumors symposium. Mod Pathol 2014; 27 (03) 472-491
- 10 Murawski M, Weeda VB, Maibach R. , et al. Hepatocellular carcinoma in children: does modified platinum- and doxorubicin-based chemotherapy increase tumor RESECTABILITY and change outcome? Lessons learned from the SIOPEL 2 and 3 Studies. J Clin Oncol 2016; 34 (10) 1050-1056
- 11 Czauderna P, Mackinlay G, Perilongo G. , et al; Liver Tumors Study Group of the International Society of Pediatric Oncology. Hepatocellular carcinoma in children: results of the first prospective study of the International Society of Pediatric Oncology group. J Clin Oncol 2002; 20 (12) 2798-2804
- 12 Katzenstein HM, Krailo MD, Malogolowkin MH. , et al. Hepatocellular carcinoma in children and adolescents: results from the Pediatric Oncology Group and the Children's Cancer Group intergroup study. J Clin Oncol 2002; 20 (12) 2789-2797
- 13 Czauderna P. Adult type vs. childhood hepatocellular carcinoma--are they the same or different lesions? Biology, natural history, prognosis, and treatment. Med Pediatr Oncol 2002; 39 (05) 519-523
- 14 Towbin AJ, Meyers RL, Woodley H. , et al. 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol 2018; 48 (04) 536-554
- 15 Meyers RL, Maibach R, Hiyama E. , et al. Risk-stratified staging in paediatric hepatoblastoma: a unified analysis from the Children's Hepatic tumors International Collaboration. Lancet Oncol 2017; 18 (01) 122-131
- 16 Schmid I, von Schweinitz D. Pediatric hepatocellular carcinoma: challenges and solutions. J Hepatocell Carcinoma 2017; 4: 15-21
- 17 Brown DB, Pilgram TK, Darcy MD. , et al. Hepatic arterial chemoembolization for hepatocellular carcinoma: comparison of survival rates with different embolic agents. J Vasc Interv Radiol 2005; 16 (12) 1661-1666
- 18 Tsochatzis EA, Fatourou E, O'Beirne J, Meyer T, Burroughs AK. Transarterial chemoembolization and bland embolization for hepatocellular carcinoma. World J Gastroenterol 2014; 20 (12) 3069-3077
- 19 Tsochatzis E, Meyer T, Marelli L, Burroughs AK. Which transarterial therapy is best for hepatocellular carcinoma?--the evidence to date. J Hepatol 2010; 53 (03) 588
- 20 Maluccio MA, Covey AM, Porat LB. , et al. Transcatheter arterial embolization with only particles for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol 2008; 19 (06) 862-869
- 21 Czauderna P, Zbrzezniak G, Narozanski W, Korzon M, Wyszomirska M, Stoba C. Preliminary experience with arterial chemoembolization for hepatoblastoma and hepatocellular carcinoma in children. Pediatr Blood Cancer 2006; 46 (07) 825-828
- 22 Lewandowski RJ, Mulcahy MF, Kulik LM. , et al. Chemoembolization for hepatocellular carcinoma: comprehensive imaging and survival analysis in a 172-patient cohort. Radiology 2010; 255 (03) 955-965
- 23 Dhand S, Gupta R. Hepatic transcatheter arterial chemoembolization complicated by postembolization syndrome. Semin Intervent Radiol 2011; 28 (02) 207-211
- 24 Marelli L, Stigliano R, Triantos C. , 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 (01) 6-25
- 25 Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 1983; 148 (02) 397-401
- 26 Nakamura H, Hashimoto T, Oi H, Sawada S. Transcatheter oily chemoembolization of hepatocellular carcinoma. Radiology 1989; 170 (3 Pt 1): 783-786
- 27 Tsurusaki M, Murakami T. Surgical and locoregional therapy of HCC: TACE. Liver Cancer 2015; 4 (03) 165-175
- 28 Craig P, Young S, Golzarian J. Current trends in the treatment of hepatocellular carcinoma with transarterial embolization: variability in technical aspects. Cardiovasc Intervent Radiol 2019; 25 (01) 16
- 29 Llovet JM, Real MI, Montaña X. , et al; Barcelona Liver Cancer Group. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359 (9319): 1734-1739
- 30 Lo CM, Ngan H, Tso WK. , et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35 (05) 1164-1171
- 31 Wong LL, Tanaka K, Lau L, Komura S. Pre-transplant treatment of hepatocellular carcinoma: assessment of tumor necrosis in explanted livers. Clin Transplant 2004; 18 (03) 227-234
- 32 Graziadei IW, Sandmueller H, Waldenberger P. , et al. Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome. Liver Transpl 2003; 9 (06) 557-563
- 33 Kamel IR, Bluemke DA, Ramsey D. , et al. Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 2003; 181 (03) 708-710
- 34 Kim CJ, Kim HJ, Park JH. , et al. Radiologic response to transcatheter hepatic arterial chemoembolization and clinical outcomes in patients with hepatocellular carcinoma. Liver Int 2014; 34 (02) 305-312
- 35 Malagari K, Pomoni M, Kelekis A. , et al. Prospective randomized comparison of chemoembolization with doxorubicin-eluting beads and bland embolization with BeadBlock for hepatocellular carcinoma. Cardiovasc Intervent Radiol 2010; 33 (03) 541-551
- 36 Facciorusso A, Licinio R, Muscatiello N, Di Leo A, Barone M. Transarterial chemoembolization: evidences from the literature and applications in hepatocellular carcinoma patients. World J Hepatol 2015; 7 (16) 2009-2019
- 37 Gerber DA, Arcement C, Carr B, Towbin R, Mazariegos G, Reyes J. Use of intrahepatic chemotherapy to treat advanced pediatric hepatic malignancies. J Pediatr Gastroenterol Nutr 2000; 30 (02) 137-144
- 38 Arcement CM, Towbin RB, Meza MP. , et al. Intrahepatic chemoembolization in unresectable pediatric liver malignancies. Pediatr Radiol 2000; 30 (11) 779-785
- 39 Malogolowkin MH, Stanley P, Steele DA, Ortega JA. Feasibility and toxicity of chemoembolization for children with liver tumors. J Clin Oncol 2000; 18 (06) 1279-1284
- 40 Weiss KE, Sze DY, Rangaswami AA. , et al. Transarterial chemoembolization in children to treat unresectable hepatocellular carcinoma. Pediatr Transplant 2018; 22 (04) e13187
- 41 Andrews JC, Walker SC, Ackermann RJ, Cotton LA, Ensminger WD, Shapiro B. Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up. J Nucl Med 1994; 35 (10) 1637-1644
- 42 Ho S, Lau WY, Leung TWT. , et al. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med 1996; 23 (08) 947-952
- 43 Lau WY, Leung WT, Ho S. , et al. Treatment of inoperable hepatocellular carcinoma with intrahepatic arterial yttrium-90 microspheres: a phase I and II study. Br J Cancer 1994; 70 (05) 994-999
- 44 Houle S, Yip TK, Shepherd FA. , et al. Hepatocellular carcinoma: pilot trial of treatment with Y-90 microspheres. Radiology 1989; 172 (03) 857-860
- 45 Blanchard RJ, Morrow IM, Sutherland JB. Treatment of liver tumors with yttrium-90 microspheres alone. Can Assoc Radiol J 1989; 40 (04) 206-210
- 46 Shepherd FA, Rotstein LE, Houle S, Yip TCK, Paul K, Sniderman KW. A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma. Cancer 1992; 70 (09) 2250-2254
- 47 Khan AS, Garcia-Aroz S, Ansari MA. , et al. Assessment and optimization of liver volume before major hepatic resection: current guidelines and a narrative review. Int J Surg 2018; 52: 74-81
- 48 Salem R, Mazzaferro V, Sangro B. Yttrium 90 radioembolization for the treatment of hepatocellular carcinoma: biological lessons, current challenges, and clinical perspectives. Hepatology 2013; 58 (06) 2188-2197
- 49 Salem R, Thurston KG. Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: technical and methodologic considerations. J Vasc Interv Radiol 2006; 17 (08) 1251-1278
- 50 Lewandowski RJ, Donahue L, Chokechanachaisakul A. , et al. (90) Y radiation lobectomy: outcomes following surgical resection in patients with hepatic tumors and small future liver remnant volumes. J Surg Oncol 2016; 114 (01) 99-105
- 51 Hayashi S, Baba Y, Ueno K. , et al. Acceleration of primary liver tumor growth rate in embolized hepatic lobe after portal vein embolization. Acta Radiol 2007; 48 (07) 721-727
- 52 Hickey RM, Lewandowski RJ, Salem R. Yttrium-90 radioembolization for hepatocellular carcinoma. Semin Nucl Med 2016; 46 (02) 105-108
- 53 Emami B, Lyman J, Brown A. , et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991; 21 (01) 109-122
- 54 Lawrence TS, Robertson JM, Anscher MS, Jirtle RL, Ensminger WD, Fajardo LF. Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys 1995; 31 (05) 1237-1248
- 55 Kulik LM, Carr BI, Mulcahy MF. , et al. Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 2008; 47 (01) 71-81
- 56 Salem R, Lewandowski RJ, Mulcahy MF. , et al. Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 2010; 138 (01) 52-64
- 57 Hilgard P, Hamami M, Fouly AE. , et al. Radioembolization with yttrium-90 glass microspheres in hepatocellular carcinoma: European experience on safety and long-term survival. Hepatology 2010; 52 (05) 1741-1749
- 58 Salem R, Lewandowski RJ, Kulik L. , et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 2011; 140 (02) 497-507.e2
- 59 Salem R, Gilbertsen M, Butt Z. , et al. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization, compared with chemoembolization. Clin Gastroenterol Hepatol 2013; 11 (10) 1358-1365.e1
- 60 Kim PH, Choi SH, Kim J-H, Park SH. Comparison of radioembolization and sorafenib for the treatment of hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis of safety and efficacy. Korean J Radiol 2019; 20 (03) 385-398 0496
- 61 Christianson D, Rizzo D. . Provision of Karnofsky performance score (KPS) versus ECOG performance score (ECOG PS) to CIBMTR. January 2009 https://www.cibmtr.org/DataManagement/TrainingReference/Manuals/DataManagement/Documents/appendix-l.pdf . Accessed May 22, 2019
- 62 Padia SA, Lewandowski RJ, Johnson GE. , et al; Society of Interventional Radiology Standards of Practice Committee. Radioembolization of hepatic malignancies: background, quality improvement guidelines, and future directions. J Vasc Interv Radiol 2017; 28 (01) 1-15
- 63 Hickey R, Mulcahy MF, Lewandowski RJ. , et al. Chemoradiation of hepatic malignancies: prospective, phase 1 study of full-dose capecitabine with escalating doses of yttrium-90 radioembolization. Int J Radiat Oncol Biol Phys 2014; 88 (05) 1025-1031
- 64 Iñarrairaegui M, Thurston KG, Bilbao JI. , et al. Radioembolization with use of yttrium-90 resin microspheres in patients with hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol 2010; 21 (08) 1205-1212
- 65 Lewandowski RJ, Geschwind J-F, Liapi E, Salem R. Transcatheter intraarterial therapies: rationale and overview. Radiology 2011; 259 (03) 641-657
- 66 Ho S, Lau WY, Leung TWT, Chan M, Johnson PJ, Li AKC. Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancer. Eur J Nucl Med 1997; 24 (03) 293-298
- 67 BTG International Ltd. TheraSphere® Yttrium-90 Glass Microspheres. Package Insert. August 2016 :1–32. https://btgplc.com/BTG/media/TheraSphere-Documents/PDF/TheraSphere-Package-Insert_USA_Rev-14.pdf
- 68 Sirtex Medical Limited. . SIR-Spheres® Y-90 Resin Microspheres. Package Insert. February 2017 :1–3. https://www.sirtex.com/us/clinicians/package-insert/
- 69 Aguado A, Ristagno R, Towbin AJ. , et al. Transarterial radioembolization with yttrium-90 of unresectable primary hepatic malignancy in children. Pediatr Blood Cancer 2019; 66 (07) e27510
- 70 Thomas MB, Jaffe D, Choti MM. , et al. Hepatocellular carcinoma: consensus recommendations of the National Cancer Institute Clinical Trials Planning Meeting. J Clin Oncol 2010; 28 (25) 3994-4005
- 71 Benson III AB, Abrams TA, Ben-Josef E. , et al. NCCN clinical practice guidelines in oncology: hepatobiliary cancers. J Natl Compr Canc Netw 2009; 7 (04) 350-391
- 72 Roebuck DJ. Paediatric interventional oncology. Cancer Imaging 2010; 10(1A): S27-S34
- 73 Hawkins CM, Kukreja K, Geller JI, Schatzman C, Ristagno R. Radioembolisation for treatment of pediatric hepatocellular carcinoma. Pediatr Radiol 2013; 43 (07) 876-881
- 74 Hong K, Georgiades C. Radiofrequency ablation: mechanism of action and devices. J Vasc Interv Radiol 2010; 21 (8, Suppl): S179-S186
- 75 Ahmed M, Liu Z, Humphries S, Goldberg SN. Computer modeling of the combined effects of perfusion, electrical conductivity, and thermal conductivity on tissue heating patterns in radiofrequency tumor ablation. Int J Hyperthermia 2008; 24 (07) 577-588
- 76 Hinshaw JL, Lubner MG, Ziemlewicz TJ, Lee Jr FT, Brace CL. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation--what should you use and why?. Radiographics 2014; 34 (05) 1344-1362
- 77 Seifert JK, Morris DL. World survey on the complications of hepatic and prostate cryotherapy. World J Surg 1999; 23 (02) 109-113 , discussion 113–114
- 78 Morimoto M, Numata K, Kondou M, Nozaki A, Morita S, Tanaka K. Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma: a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization. Cancer 2010; 116 (23) 5452-5460
- 79 Livraghi T, Goldberg SN, Lazzaroni S. , et al. Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 2000; 214 (03) 761-768
- 80 Gervais DA, Goldberg SN, Brown DB, Soulen MC, Millward SF, Rajan DK. Society of Interventional Radiology position statement on percutaneous radiofrequency ablation for the treatment of liver tumors. J Vasc Interv Radiol 2009; 20 (7, Suppl): S342-S347
- 81 Xu HX, Xie XY, Lu MD. , et al. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation. Clin Radiol 2004; 59 (01) 53-61
- 82 Zhang NN, Lu W, Cheng XJ, Liu JY, Zhou YH, Li F. High-powered microwave ablation of larger hepatocellular carcinoma: evaluation of recurrence rate and factors related to recurrence. Clin Radiol 2015; 70 (11) 1237-1243
- 83 Wang C, Wang H, Yang W. , et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology 2015; 61 (05) 1579-1590
- 84 Rong G, Bai W, Dong Z. , et al. Long-term outcomes of percutaneous cryoablation for patients with hepatocellular carcinoma within Milan criteria. PLOS One 2015; 10 (04) e0123065
- 85 van Laarhoven S, van Baren R, Tamminga RYJ, de Jong KP. Radiofrequency ablation in the treatment of liver tumors in children. J Pediatr Surg 2012; 47 (03) e7-e12
- 86 Yevich S, Calandri M, Gravel G. , et al. Reiterative radiofrequency ablation in the management of pediatric patients with hepatoblastoma metastases to the lung, liver, or bone. Cardiovasc Intervent Radiol 2019; 42 (01) 41-47
- 87 Liu B, Zhou L, Huang G. , et al. First experience of ultrasound-guided percutaneous ablation for recurrent hepatoblastoma after liver resection in children. Sci Rep 2015; 5 (01) 16805
- 88 Chu KF, Dupuy DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat Rev Cancer 2014; 14 (03) 199-208
- 89 Sangro B, Gomez-Martin C, de la Mata M. , et al. A clinical trial of CTLA-4 blockade with tremelimumab in patients with hepatocellular carcinoma and chronic hepatitis C. J Hepatol 2013; 59 (01) 81-88
- 90 Greten TF, Mauda-Havakuk M, Heinrich B, Korangy F, Wood BJ. Combined locoregional-immunotherapy for liver cancer. J Hepatol 2019; 70 (05) 999-1007