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Locoregional therapies have become part of the standard of care in treatment of hepatocellular carcinoma. While transarterial chemoembolization (TACE) was the original treatment of choice, many studies have demonstrated benefits of transarterial radioembolization (TARE) over other treatment options. While there is no proven survival benefit between TACE and TARE, especially when confined to Barcelona Clinic Liver Cancer (BCLC) system stage B intermediate disease, multiple studies have demonstrated increased time to progression with TARE over TACE. TARE is also the preferred treatment method for patients with HCC and concurrent portal vein thrombosis (PVT). Additionally, TARE delivered as a radiation lobectomy is useful for bridging to resection in patients with HCC and small future liver remnants (FLRs). Furthermore, studies indicate TARE is more cost-effective than TACE, and prospective studies demonstrate improved quality of life (QoL) over TACE.

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Should Transarterial Radioembolization Be the First-Line Therapy Compared to Transarterial Chemoembolization for Intermediate-Stage Hepatocellular Carcinoma?

  • 章节

  • 发表日期：

    2025年

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  • Alexandra Morris,
  • Stefan Brancel,
  • Scott Schwartz

摘要

Locoregional therapies have become part of the standard of care in treatment of hepatocellular carcinoma. While transarterial chemoembolization (TACE) was the original treatment of choice, many studies have demonstrated benefits of transarterial radioembolization (TARE) over other treatment options. While there is no proven survival benefit between TACE and TARE, especially when confined to Barcelona Clinic Liver Cancer (BCLC) system stage B intermediate disease, multiple studies have demonstrated increased time to progression with TARE over TACE. TARE is also the preferred treatment method for patients with HCC and concurrent portal vein thrombosis (PVT). Additionally, TARE delivered as a radiation lobectomy is useful for bridging to resection in patients with HCC and small future liver remnants (FLRs). Furthermore, studies indicate TARE is more cost-effective than TACE, and prospective studies demonstrate improved quality of life (QoL) over TACE.