Interventional Oncology

Abstract

Early successes in interventional oncology, an interventional radiology subspecialty, emerged in the treatment of a malignancy long proven difficult for oncologists to treat: hepatocellular carcinoma (HCC), which was often caught too late for a patient to be eligible for treatments with curative potential, such as surgery or liver transplantation (Liu et al., Cold Spring Harb Perspect Med 5(9):a021535, 2015). As hepatic tumors are predominantly supplied by the hepatic artery (Kalva et al., Radiographics 28(1):101–117, 2008), while liver parenchyma is predominantly supplied by the portal vein (Kalva et al., Radiographics 28(1):101–117, 2008), through establishing a transarterial route, chemotherapeutic drugs could be directly infused via the hepatic artery, resulting in higher local concentrations of chemotherapeutic agent at the location of the malignancy (Kalva et al., Radiographics 28(1):101–117, 2008). This reduces tumor burden in HCC, improving mortality and morbidity and allowing patients to longer maintain eligibility for curative treatments (Kalva et al., Radiographics 28(1):101–117, 2008). With the development of minimally invasive image-guided techniques for the treatment and management of tumors in the body, interventional oncology is now considered the fourth pillar of cancer care along with surgery, radiation oncology, and medical oncology (Kanazawa, Int J Clin Oncol 17(4):299–300, 2012). Interventional oncology procedures, with their ability to target cancer cells in highly specific and localized fashion, generally result in less morbidity than surgery and are lower in toxicity than chemotherapy and radiation (Kanazawa, Int J Clin Oncol 17(4):299–300, 2012). These procedures can function as primary therapy, and some modalities can achieve local cure (Adam and Kenny, Nat Rev Clin Oncol 12(2):105–113, 2015), in conjunction with other therapies for optimal management of cancer or palliation of symptoms in suitable patients, or play a role in management, such as in intraprocedural monitoring.