Assessment of the HCC Patient

Assessment of the HCC Patient

Thursday, March 31, 2005 Clinical Oncology: What the IR Needs to Know (SY) Coordinators: Thierry de Baere, MD, Damian Dupuy, MD, Catherine M. Tuite, M...

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Thursday, March 31, 2005 Clinical Oncology: What the IR Needs to Know (SY) Coordinators: Thierry de Baere, MD, Damian Dupuy, MD, Catherine M. Tuite, MD, Michael C. Soulen, MD

Objectives: Upon completion of this symposium, the attendee should be able to: 1. Describe the biology, epidemiology, and natural histOly of common solid tumors.

2. Work up, diagnose and stage patients with cancers who may be candidates for image-guided therapy.

1:40 p.m. The Original Image-Guided Therapy: The Role of Radiation in Tumors Amenable to IGT Thomas DiPetril!o, MD Rhode Island Hospital ProVidence, Rl 2:00 p.m. BREAK

Who To Treat, When and How: Integrating IGT into the Global Care of Cancer Patients Moderator: Damian E. DUpuy, MD

3. Integrate image-guided therapy (IUD with chemotherapy, radiation, and surgery for specific solid cancers.

2:15 p.m.

4. Clinically evaluate and care for patients with cancer and cancer treatment-related toxicities.

Hepatic Metastases: Medical Oncology Paolo Hoff, MD 2:30 p.m.

Principles Of Oncology: What You Need to Know for the Initial Consultation And Why It Matters Moderator: Catherine M. TUite, MD 12:00 p.m. General Assessment of the Cancer Patient Catherine M. Tuite, MD Hospital of the University of Pennsylvania Philadelphia, PA 12:20 p.m. Assessment of the HCC Patient Riad Salem, MD, MBA Northwestern Memorial Hospital Chicago,IL 12:40 p.m. Chemotherapy: What We Use, What They Use, and Why You Should Care Paolo Hoff, MD 1:00 p.m. When and How to Image for Tumor Response: cr/MRI After IGT David Lu, MD Dumont UCLA Liver Cancer Centre CA See Limanond P, Zimmerman P, Raman SS, Kadell BM, Lu DS. Interpretation of CT and MRI after radiofrequency ablation of hepatic malignancies. AJR 2003; 181:1635-1640 1:20 p.m. When and How to Image for Tumor Response: PET After IGT Homer Macapinlac, MD


Hepatic Malignancies: Rationale for Local and Regional Therapies Thierry de Baere, MD Institut Gustave Roussy Villejuif, France Due to the relative inefficacy of general treatment of liver tumors, there is a large place for so called "local" and "regional" therapies in this field. It is very difficult to make a clear cut difference between what is called a "local" treatment and a "regional" treatment and both words are used in the literature without clear significance. Local most often means targeting the tumor, while regional means targeting the organ or the region of the disease. The goal of all these treatments is to target the tumor as accurately and selectively as possible. Because we are not able to be so selective with the tumor, we enlarged treatment to healthy parenchyma around it. If we thought about ablative therapies, we took safety margins, and somewhat transformed a local to loco-regional treatment. If we thought about chemoembolization, we tried to be as selective as possible to go from a regional treatment to the liver into a local treatment by targeting the lobe, the segment or even the subsegment bearing the tumor according to our technical possibilities, and probably providing a loco-regional treatment as well. Consequently, we will use the term loco-regional in the syllabus both for ablative and intra-arterial techniques even if their rational is different. Numerous and various loco-regional treatments have been used for many years in cancer management including: radiation therapy, brachytherapy, regional chemotherapy delivery (intra-arterial, intra-peritoneal, ...), and obviously surgery. These treatments can provide dramatic results and cure the patient in some occasions when the disease is limited. Indeed, surgery, a locoregional treatment, provides the best hope for cure and