Management of unresectable intrahepatic cholangiocarcinoma: how do we decide among the various liver-directed treatments?

Cancer research · Cholangiocarcinoma

Technological advances in radiation oncology and interventional radiology have enabled the delivery of ablative radiation doses or other cytotoxic therapies for tumors in the liver, potentially prolonging survival in patients with unresectable intra‑hepatic cholangiocarcinoma.

Intrahepatic cholangiocarcinoma often causes death due to obstruction of the biliary system or interruption of the vascular supply of the liver. This fact emphasizes the critical need for local tumor control in this disease. Successful local tumor control has traditionally been achievable through surgical resection for the small proportion of patients with operable tumors. Technological advances in radiation oncology and in interventional radiology have enabled the delivery of ablative radiation doses or other cytotoxic therapies for tumors in the liver. In some cases, this has translated into substantial prolongation of life for patients with this disease, but the indications for these different treatment options are still the subject of ongoing debate. Here, we review the technological advances and clinical studies that are changing the way intrahepatic cholangiocarcinoma is managed, and discuss ways to achieve individualized treatment of patients.

Local tumor control is critical because the majority of patients with unresectable intra‑hepatic cholangiocarcinoma die from tumor‑related liver failure caused by biliary or vascular obstruction.

Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.

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