Intra-arterial Hepatic Chemotherapy, Chemoembolisation and Radioembolisation: a Significant Contribution in the Treatment of Colorectal Cancer Liver Metastases

Local treatment of liver metastases (LM) of colorectal adenocarcinomas (CRC) has an emerging role in strategies of treatment for patients with limited or predominant unresectable LM. Hepatic intra-arterial chemotherapy (HIAC) demonstrated efficacy. Its combination with systemic chemotherapy allowed to double the response rate, and increased the rate of secondary resection and survival of patients. The effectiveness of chemoembolization (CE) and radio-embolization (RE) was primarily established from Phase II or Phase III evaluation of patients in very advanced stages, and progression-free survival and overall survival were increased. The role of these treatments at earlier stages is being evaluated and is expected to optimize the care of patients with LM. These local treatments must now be used in combination with effective systemic therapies, and/or resection, and the choice of the best strategies and protocols must be done in specialized team with collaboration of expert radiologist, nuclear medicine and oncologist.