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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. May 28, 2016; 8(5): 449-459
Published online May 28, 2016. doi: 10.4329/wjr.v8.i5.449
Current status of transarterial radioembolization
Andreas H Mahnken
Andreas H Mahnken, Department of Diagnostic and Interventional Radiology, University Hospital, Philipps-University, 35043 Marburg, Germany
Author contributions: Conception and design of the manuscript, literature review and analysis, drafting, editing and final approval of the manuscript were performed by Mahnken AH.
Conflict-of-interest statement: There is no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Andreas H Mahnken, MD, MBA, MME, Department of Diagnostic and Interventional Radiology, University Hospital, Philipps-University, Baldingerstrasse, 35043 Marburg, Germany. mahnken@med.uni-marburg.de
Telephone: +49-6421-5866231 Fax: +49-6421-5868959
Received: August 12, 2015
Peer-review started: August 18, 2015
First decision: September 28, 2015
Revised: February 3, 2016
Accepted: March 9, 2016
Article in press: March 14, 2016
Published online: May 28, 2016
Processing time: 279 Days and 18.1 Hours
Abstract

Unresectable primary and secondary liver malignancies present a major problem in the treatment of solid tumors. Transarterial radioembolization (TARE) is an increasingly used technique for treating various types of malignant liver tumors. This approach is appealing, as the mechanism of action is independent from other loco-regional treatments and potentially complementary to systemic therapies. There are two commercially available products in use for TARE: 90Y-resin and 90Y-glass microspheres. Currently available data indicates TARE so be safe and effective in hepatocellular carcinoma (HCC) and metastatic liver disease. In HCC the results compare well with chemoembolization, while the role of TARE in combination with kinase inhibitors has yet to be established. Current data on TARE in metastatic liver disease is promising, but there is a strong need for prospective randomized trials comparing TARE and modern chemotherapeutic regimen to support the growing role of TARE in metastatic liver disease.

Keywords: Hepatocellular carcinoma; Selective internal radiation therapy; Radioembolization; Liver; Neoplasm; Metastasis

Core tip: Transarterial radioembolization (TARE) with 90Y microspheres is a targeted therapy indicated for unresectable primary and secondary liver malignancies. Current data proves its safety and effectiveness, but its definitive role in the treatment of hepatocellular carcinoma and metastatic liver disease within interdisciplinary treatment algorithms is still to be established. There is a strong need for randomized controlled trials comparing TARE to transarterial chemoembolization in primary liver cancer and to modern chemotherapeutic regimen in metastatic liver disease.