chemotherapy: what we use, what they use, and why you should care

P4

Thursday, March 31, 2005

Clinical Oncology: What the IR Needs toKnow (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 his­

tOly of common solid tumors.

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

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

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

Principles Of Oncology: What You Need toKnow for the Initial Consultation And Why ItMatters

Moderator: Catherine M. TUite, MD

12:00 p.m.

General Assessment of the Cancer PatientCatherine M. Tuite, MDHospital of the University ofPennsylvaniaPhiladelphia, PA

12:20 p.m.

Assessment of the HCC PatientRiad Salem, MD, MBANorthwestern Memorial HospitalChicago,IL

12:40 p.m.

Chemotherapy: What We Use, What They Use,and Why You Should CarePaolo Hoff, MD

1:00 p.m.

When and How to Image for Tumor Response:cr/MRI After IGTDavid Lu, MDDumont UCLA Liver Cancer Centre

CA

See Limanond P, Zimmerman P, Raman SS, Kadell BM,Lu DS. Interpretation of CT and MRI afterradiofrequency ablation of hepatic malignancies. AJR2003; 181:1635-1640

1:20 p.m.

When and How to Image for Tumor Response:PET After IGTHomer Macapinlac, MD

1:40 p.m.

The Original Image-Guided Therapy: The Role ofRadiation in Tumors Amenable to IGTThomas DiPetril!o, MDRhode Island HospitalProVidence, Rl

2:00 p.m.

BREAK

Who To Treat, When and How: IntegratingIGT into the Global Care of Cancer Patients

Moderator: Damian E. DUpuy, MD

2:15 p.m.

Hepatic Metastases: Medical OncologyPaolo Hoff, MD

2:30 p.m.

Hepatic Malignancies: Rationale for Local andRegional Therapies

Thierry de Baere, MDInstitut Gustave RoussyVillejuif, FranceDue to the relative inefficacy of general treatment of livertumors, there is a large place for so called "local" and"regional" therapies in this field.

It is very difficult to make a clear cut differencebetween what is called a "local" treatment and a "re­gional" treatment and both words are used in the litera­ture without clear significance. Local most often meanstargeting the tumor, while regional means targeting theorgan or the region of the disease. The goal of all thesetreatments is to target the tumor as accurately and selec­tively as possible. Because we are not able to be soselective with the tumor, we enlarged treatment tohealthy parenchyma around it. If we thought about ab­lative therapies, we took safety margins, and somewhattransformed a local to loco-regional treatment. If wethought about chemoembolization, we tried to be asselective as possible to go from a regional treatment tothe liver into a local treatment by targeting the lobe, thesegment or even the subsegment bearing the tumoraccording to our technical possibilities, and probablyproviding 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 iftheir rational is different.

Numerous and various loco-regional treatments havebeen used for many years in cancer management includ­ing: radiation therapy, brachytherapy, regional chemo­therapy delivery (intra-arterial, intra-peritoneal, ...), andobviously surgery. These treatments can provide dra­matic results and cure the patient in some occasionswhen the disease is limited. Indeed, surgery, a loco­regional treatment, provides the best hope for cure and