Transarterial chemoembolization, transarterial chemotherapy, and intra-arterial chemotherapy for hepatocellular carcinoma treatment.

Intra-arterial (IA) therapies for hepatocellular carcinoma (HCC) are considered palliative and should be offered to patients with intermediate-stage multinodular disease and with sufficient liver reserve. They include transarterial chemoembolization (TACE) or bland embolization, transarterial chemotherapy, and transarterial radioembolization. While transarterial therapy is now a validated treatment for unresectable HCC, there is still controversy as to which type is the optimal procedure. This is mainly due to the lack of standardization. Combining local therapies or IA therapies with systemic targeted therapies might prove more effective strategies in the future. In this article, we review transarterial therapies and critically comment on their clinical applications. Copyright 2010 Elsevier Inc. All rights reserved.