Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards f...Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC;however,advances in imaging and minimally invasive techniques have improved patient selection and outcomes.Additionally,the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC.This review highlights the efficacy of agents such as tyrosine kinase inhibitors,alongside emerging options like immune checkpoint inhibitors,which have shown promise in clinical trials.Furthermore,the role of locoregional therapies,including ablation in the setting of combined treatment,transar-terial chemoembolization and transarterial radioembolization with flow catheters,cone-beam computed tomo-graphy and 4D navigation guidance,is examined in the context of bridging therapies for patients awaiting surgical intervention.The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes.Future directions for HCC treatment are discussed,including the potential of novel biomarkers in prognosis and treatment response.This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.展开更多
The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high...The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging.Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files:This image numerical analysis has been named“radiomics”.Radiomics allows the extraction of quantitative features from radiological images,mainly invisible to the naked eye,that can be further analyzed by artificial intelligence algorithms.Radiomics is expanding in oncology to either understand tumor biology or for the development of imaging biomarkers for diagnosis,staging,and prognosis,prediction of treatment response and diseases monitoring and surveillance.Several efforts have been made to develop radiomics signatures for colorectal cancer patient using computed tomography(CT)images with different aims:The preoperative prediction of lymph node metastasis,detecting BRAF and RAS gene mutations.Moreover,the use of delta-radiomics allows the analysis of variations of the radiomics parameters extracted from CT scans performed at different timepoints.Most published studies concerning radiomics and magnetic resonance imaging(MRI)mainly focused on the response of advanced tumors that under-went neoadjuvant therapy.Nodes status is the main determinant of adjuvant chemotherapy.Therefore,several radiomics model based on MRI,especially on T2-weighted images and ADC maps,for the preoperative prediction of nodes metastasis in rectal cancer has been developed.Current studies mostly focused on the applications of radiomics in positron emission tomogra-phy/CT for the prediction of survival after curative surgical resection and assessment of response following neoadjuvant chemoradiotherapy.Since colorectal liver metastases develop in about 25%of patients with colorectal carcinoma,the main diagnostic tasks of radiomics should be the detection of synchronous and metachronous lesions.Radiomics could be an additional tool in clinical setting,especially in identifying patients with high-risk disease.Nevertheless,radiomics has numerous shortcomings that make daily use extremely difficult.Further studies are needed to assess performance of radiomics in stratifying patients with high-risk disease.展开更多
Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of tumors.This percutaneous technique involves the local,intra-arterial deliv...Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of tumors.This percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the tumor.Historically employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation segmentectomy.The latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not feasible.Radiation segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy tissue.Future research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.展开更多
Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic option.I...Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic option.It represents most common primary malignancy of the liver,developing in 90%of cases of un underlying liver disease(1)[chronic HBV and HCV hepatitis,dysmetabolic liver disease].展开更多
文摘Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC;however,advances in imaging and minimally invasive techniques have improved patient selection and outcomes.Additionally,the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC.This review highlights the efficacy of agents such as tyrosine kinase inhibitors,alongside emerging options like immune checkpoint inhibitors,which have shown promise in clinical trials.Furthermore,the role of locoregional therapies,including ablation in the setting of combined treatment,transar-terial chemoembolization and transarterial radioembolization with flow catheters,cone-beam computed tomo-graphy and 4D navigation guidance,is examined in the context of bridging therapies for patients awaiting surgical intervention.The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes.Future directions for HCC treatment are discussed,including the potential of novel biomarkers in prognosis and treatment response.This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.
文摘The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging.Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files:This image numerical analysis has been named“radiomics”.Radiomics allows the extraction of quantitative features from radiological images,mainly invisible to the naked eye,that can be further analyzed by artificial intelligence algorithms.Radiomics is expanding in oncology to either understand tumor biology or for the development of imaging biomarkers for diagnosis,staging,and prognosis,prediction of treatment response and diseases monitoring and surveillance.Several efforts have been made to develop radiomics signatures for colorectal cancer patient using computed tomography(CT)images with different aims:The preoperative prediction of lymph node metastasis,detecting BRAF and RAS gene mutations.Moreover,the use of delta-radiomics allows the analysis of variations of the radiomics parameters extracted from CT scans performed at different timepoints.Most published studies concerning radiomics and magnetic resonance imaging(MRI)mainly focused on the response of advanced tumors that under-went neoadjuvant therapy.Nodes status is the main determinant of adjuvant chemotherapy.Therefore,several radiomics model based on MRI,especially on T2-weighted images and ADC maps,for the preoperative prediction of nodes metastasis in rectal cancer has been developed.Current studies mostly focused on the applications of radiomics in positron emission tomogra-phy/CT for the prediction of survival after curative surgical resection and assessment of response following neoadjuvant chemoradiotherapy.Since colorectal liver metastases develop in about 25%of patients with colorectal carcinoma,the main diagnostic tasks of radiomics should be the detection of synchronous and metachronous lesions.Radiomics could be an additional tool in clinical setting,especially in identifying patients with high-risk disease.Nevertheless,radiomics has numerous shortcomings that make daily use extremely difficult.Further studies are needed to assess performance of radiomics in stratifying patients with high-risk disease.
文摘Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of tumors.This percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the tumor.Historically employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation segmentectomy.The latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not feasible.Radiation segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy tissue.Future research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.
文摘Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic option.It represents most common primary malignancy of the liver,developing in 90%of cases of un underlying liver disease(1)[chronic HBV and HCV hepatitis,dysmetabolic liver disease].
