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Ricke, J. and Zech, C. J. (2018): Bildgeführte radiologische Interventionen beim HCC. In: Onkologe, Vol. 24, No. 9: pp. 692-697

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Background. Image-guided interventions, such as radiofrequency or microwave ablation, computed tomography (CT)- guided brachytherapy or stereotaxis (SBRT), chemoembolization or Y90 radioembolization are part of the current guidelines on treatment of hepatocellular carcinoma (HCC) and are subject to continuous validation in current clinical studies. Objective. This article gives an overview of the current state of evidence and guideline recommendations on the named radiological, nuclear medicine and radiotherapeutic procedures. Results. Local tumor ablation and locoregional chemoembolization are part of all essential guidelines on the treatment of HCC. The image-guided tumor ablation in stages BCLC A and also BCLC 0 represent nowadays an equivalent alternative to surgical resection, when patient selection is correspondingly adapted. As locoregional treatment, chemoembolization in stage BCLC B is the standard treatment in cases of well-preserved liver function and limited tumor load. No randomized data are available for the use of yttrium-90 radioembolization. For patients with BCLC C, chemoembolization is not indicated. As an alternative in cases of failure of systemic therapy or contraindications for sorafenib and also with a view to the clearly better tolerability compared to sorafenib, yttrium-90 radioembolization can be considered.

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