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Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
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Radioembolization-induced liver disease: a systematic review
Manon N G J A Braat1, Karel J van Erpecum, Bernard A Zonnenberg
1Departments of aRadiology and Nuclear Medicine bGastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands.
European Journal of Gastroenterology & Hepatology
|December 8, 2016
Summary
Radioembolization (RE) can cause liver injury, but symptomatic RE-induced liver disease (REILD) is rare. Current reporting lacks a uniform definition, hindering research and treatment development for this hepatic malignancy therapy.
Area of Science:
- Hepatology
- Interventional Radiology
- Oncology
Background:
- Radioembolization (RE) is a treatment for liver cancers using radioactive microspheres.
- Microsphere deposition can cause radiation-induced liver injury, including lethal RE-induced liver disease (REILD).
- Current definitions and reporting of REILD are inconsistent.
Purpose of the Study:
- To evaluate RE-related hepatotoxicity.
- To review definitions and characteristics of REILD.
- To propose a unifying definition and grading system for REILD.
Main Methods:
- Systematic literature search for studies defining REILD post-2008.
- Comparison of reported hepatotoxicity and REILD definitions.
- Analysis of REILD incidence and outcomes.
Main Results:
- Liver biochemistry abnormalities are common post-RE but usually self-limiting.
- Symptomatic REILD incidence varies (0-31%), with a 0-5% fatality rate.
- No uniform REILD definition exists; presentation is similar in cirrhotic and non-cirrhotic patients (except bilirubin).
Conclusions:
- RE-related hepatotoxicity is frequent, but symptomatic REILD is uncommon.
- Variable reporting of REILD impedes reliable comparisons and research.
- A proposed unifying definition and grading system aim to standardize REILD assessment.
