Intrahepatic cholangiocarcinoma (ICC) is a rare disease with a rising incidence. While surgical resection is the only curative option, the disease process is often identified in advanced stages, as this malignancy often remains clinically silent in early development. Only one-third of patients are eligible for resection at the time of diagnosis. For patients who cannot undergo resection, intra-arterial therapies are reasonable palliative treatment options; in rare occasions, these may be bridging therapies, as well. The premise of bland embolization and most chemoembolization intra-arterial therapies is that the arterial supply of the tumor is occluded to induce tumor necrosis, while radioembolization utilizes the arterial flow of the tumor to deliver radiation therapy. In this review, we discuss the use of transarterial embolization, transarterial chemoembolization, and selective internal radiation therapy for the treatment of ICC. Phase III randomized controlled clinical trials are difficult to tailor to this extremely rare and aggressive disease, but ultimately, further investigation should be pursued to define the patient population that will derive the greatest benefit from each modality.
肝内胆管癌是一种发病率逐渐上升的罕见疾病。虽然手术切除是唯一根治性治疗手段，但由于该恶性肿瘤早期发展常无临床症状，多数患者在确诊时已进展至晚期。仅约三分之一患者在诊断时符合切除条件。对于无法接受切除手术的患者，动脉内介入治疗是合理的姑息治疗方案；在极少数情况下，这些疗法也可作为桥接治疗手段。单纯栓塞和大多数动脉内化疗栓塞治疗的基本原理是通过阻断肿瘤动脉血供诱导肿瘤坏死，而放射栓塞则利用肿瘤的动脉血流进行放射治疗。本文综述了经动脉栓塞术、经动脉化疗栓塞术及选择性内放射治疗在肝内胆管癌治疗中的应用。针对这种极为罕见且侵袭性强的疾病，开展III期随机对照临床试验存在诸多困难，但最终仍需通过深入研究，明确能从不同治疗模式中获得最大获益的患者群体。
Locoregional Therapy for Intrahepatic Cholangiocarcinoma: The Role of Intra-Arterial Therapies
肿瘤(癌症)患者之家