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Tratamiento del cáncer de hígado

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Tratamiento del cáncer de hígado

Access exceptional care for liver cancer and other types of gastrointestinal cancers at Montefiore Einstein Comprehensive Cancer Center. Our multidisciplinary team has extensive experience caring for this cancer. As one of the first NCI-designated cancer centers, for more than 50 years, we’ve been a leader in the research, diagnosis and treatment of over 200 types of cancer.

We’re at the forefront of treatment and research for liver cancer and other gastrointestinal cancers. Montefiore Einstein Comprehensive Cancer Center delivers advanced, patient-centered, multidisciplinary care designed to maximize treatment outcomes while optimizing the quality of life for each patient. The overwhelming majority of our patients enjoy a return to normal liver function after surgery.

When you need liver cancer care, turn to our providers who are passionate about ending cancer and addressing your whole health needs.

We offer advanced, groundbreaking treatments and a range of minimally invasive procedures.

Some of the advanced approaches we offer include:

  • 3D imaging of the liver to help in treatment planning
  • State-of-the-art MRI and CT scanners that permit high resolution imaging of liver tumors
  • Stereotactic radiosurgery for treatment of noninvasive liver tumors
  • Proton beam radiosurgery for precise targeting of liver tumors
  • Advanced systemic therapy using monoclonal antibodies
  • Advanced genetic analysis of tumors to personalize your care plan
  • Hepatic artery radioembolization of liver tumors using Yttrium-90 (Y90) beads
  • Chemoembolization using drug eluting beads
  • Percutaneous ablation of liver tumors
  • Portal vein embolization to facilitate liver resection
  • TIPS procedure for complications of cirrhosis

Our surgeons are among the nation’s most highly skilled in open liver surgery and laparoscopic liver surgery.

Learn more about our overall expertise in the treatment of liver cancer, as well as the multidisciplinary care we can provide for all liver-related issues including nutritional evaluation, transplantation, pediatric liver disease and more through Montefiore Einstein’s multidisciplinary Liver Program.

El Montefiore Einstein Comprehensive Cancer Center, designado como centro integral del cáncer por el National Cancer Institute (NCI), apoya la misión y las normas del NCI. La siguiente información sobre los tipos de cáncer, prevención y tratamientos ha sido facilitada por el NCI.

Tratamiento del cáncer de hígado

There are different types of treatment for people with liver cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.

Tipos de tratamiento

Vigilancia

Surveillance is used for lesions smaller than 1 centimeter found during screening. Follow-up every 3 months is common. Surveillance is closely watching a person's condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. During active surveillance, certain exams and tests are done on a regular schedule.

Cirugía

A partial hepatectomy (surgery to remove the part of the liver where cancer is found) may be done. A wedge of tissue, an entire lobe, or a larger part of the liver, along with some of the healthy tissue around it is removed. The remaining liver tissue takes over the functions of the liver and may regrow.

Trasplante de hígado

In a liver transplant, the entire liver is removed and replaced with a healthy donated liver. A liver transplant may be done when the disease is in the liver only and a donated liver can be found. If the person has to wait for a donated liver, other treatment is given as needed.

Terapia de ablación

La terapia de ablación extirpa o destruye tejido. Se utilizan diferentes tipos de terapia de ablación para el cáncer de hígado:

  • Ablación por radiofrecuencia: se insertan agujas especiales directamente a través de la piel o mediante una incisión en el abdomen para alcanzar el tumor. Las ondas de radio de alta energía calientan las agujas y el tumor, lo que destruye las células cancerosas.
  • Terapia de microondas: el tumor se expone a altas temperaturas generadas por microondas. Esto puede dañar y destruir las células cancerosas o hacerlas más sensibles a los efectos de la radiación y ciertos medicamentos para el cáncer.
  • Percutaneous ethanol injection: A small needle is used to inject ethanol (pure alcohol) directly into a tumor to kill cancer cells. Several treatments may be needed. Usually local anesthesia is used, but if the person has many tumors in the liver, general anesthesia may be used.
  • Cryoablation: An instrument is used to freeze and destroy cancer cells. This type of treatment is also called cryotherapy and cryosurgery. The doctor may use ultrasound to guide the instrument. Learn more at Cryosurgery to Treat Cancer.
  • Terapia de electroporación: se envían pulsos eléctricos a través de un electrodo colocado en un tumor para destruir las células cancerosas. La terapia de electroporación se está estudiando en ensayos clínicos.

Terapia de embolización

Embolization therapy is used for people who cannot have surgery to remove the tumor or ablation therapy and whose tumor has not spread outside the liver. Embolization therapy is the use of substances to block or decrease the flow of blood through the hepatic artery to the tumor. When the tumor does not get the oxygen and nutrients it needs, it will not continue to grow.

El hígado recibe sangre de la vena porta hepática y de la arteria hepática. La sangre de la vena porta hepática suele dirigirse al tejido hepático sano, mientras que la proveniente de la arteria hepática suele dirigirse al tumor. Cuando se bloquea la arteria hepática durante la embolización, el tejido hepático sano sigue recibiendo sangre de la vena porta.

Existen dos tipos principales de terapia de embolización:

  • Embolización transarterial (ETA): se realiza una pequeña incisión (corte) en la cara interna del muslo y se inserta un catéter (tubo delgado y flexible) a través de la arteria hepática. Una vez colocado el catéter, se inyecta una sustancia que bloquea la arteria e impide el flujo sanguíneo hacia el tumor.
  • Quimioembolización transarterial (QETA): este procedimiento es similar a la ETA, pero también se administra un medicamento anticanceroso. El procedimiento puede realizarse uniendo el medicamento para el cáncer a pequeñas perlas que se inyectan en la arteria hepática, o bien inyectándolo a través de un catéter en la arteria hepática y luego administrando una sustancia para bloquearla. La mayor parte del medicamento anticanceroso queda atrapado cerca del tumor y solo una pequeña cantidad llega a otras partes del cuerpo. Este tipo de tratamiento también se denomina quimioembolización.

Terapia dirigida

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies used to treat advanced liver cancer include:

Learn more about targeted therapy and its side effects at Targeted Therapy to Treat Cancer.

Inmunoterapia

Immunotherapy is a treatment that uses the person's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.

Immune checkpoint inhibitors are a type of immunotherapy. Immune checkpoint inhibitors that may be used to treat liver cancer include:

Learn more about immunotherapy and its side effects at Immunotherapy to Treat Cancer and Immunotherapy Side Effects.

Radioterapia

External radiation therapy uses a machine outside the body to send high-energy x-rays or other types of radiation toward the area of the body with cancer. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective. The number of treatments is based on details about the cancer, such as the size and location of the tumor. Certain ways of giving external radiation therapy can help keep radiation from damaging nearby healthy tissue:

  • Radioterapia conformada: la radioterapia conformada utiliza una computadora para crear una imagen tridimensional (3D) del tumor y adapta los haces de radiación para que se ajusten a este, lo que permite que llegue una dosis alta de radiación al tumor y provoca menos daño al tejido sano circundante.
  • Stereotactic body radiation therapy: Stereotactic body radiation therapy uses special equipment to place the person in the same position for each radiation treatment. Once a day for several days, a radiation machine aims a larger than usual dose of radiation directly at the tumor. By having the person in the same position for each treatment, there is less damage to nearby healthy tissue. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.
  • Radioterapia con haz de protones: es un tipo de radioterapia externa de alta energía que utiliza corrientes de protones (partículas diminutas con carga positiva) para destruir las células tumorales. Este tipo de tratamiento puede reducir el daño causado por la radiación al tejido sano circundante a un tumor.

Learn more about radiation therapy and its side effects at Radiation Therapy to Treat Cancer and Radiation Therapy Side Effects.

Ensayos clínicos

Un ensayo clínico de tratamiento es un estudio de investigación diseñado para mejorar los tratamientos actuales o explorar nuevas opciones para pacientes con cáncer. Para algunos pacientes, participar en un ensayo clínico puede ser una alternativa viable.

Utilice nuestra herramienta de búsqueda de ensayos clínicos para encontrar ensayos clínicos sobre el cáncer respaldados por el NCI que admitan pacientes. Puede buscar ensayos según el tipo de cáncer, la edad del paciente y el lugar donde se realizan. Los ensayos clínicos respaldados por otras organizaciones se pueden encontrar en el sitio web ClinicalTrials.gov.

Para obtener más información sobre los ensayos clínicos, consulte Información sobre estudios clínicos para pacientes y cuidadores.

Tratamiento del cáncer de hígado localizado

Treatment of localized liver cancer may include:

  • Vigilancia de lesiones de menos de 1 centímetro
  • partial hepatectomy (surgery to remove the part of the liver where cancer is found)
  • liver transplant
  • ablation of the tumor using:
    • Ablación por radiofrecuencia
    • Terapia de microondas
    • Inyección percutánea de etanol
    • Crioablación
  • Radioterapia

Tratamiento del cáncer de hígado localmente avanzado o metastásico

Treatment of locally advanced or metastatic liver cancer may include:

  • transarterial embolization (TAE) or transarterial chemoembolization (TACE) in people with locally advanced liver cancer
  • bevacizumab, cabozantinib, lenvatinib, ramucirumab, regorafenib, or sorafenib
  • atezolizumab with bevacizumab or cabozantinib, durvalumab with tremelimumab, nivolumab with ipilimumab, or pembrolizumab
  • Radioterapia

Tratamiento del cáncer de hígado recidivante

Treatment options for recurrent primary liver cancer may include:

  • total hepatectomy (surgery to remove all of the liver) and liver transplant
  • partial hepatectomy (surgery to remove the part of the liver where cancer is found)
  • ablation therapy
  • transarterial chemoembolization (TACE) and sorafenib as palliative therapy to relieve symptoms and improve quality of life

Updated: May 2, 2024

This content is provided by the National Cancer Institute (www.cancer.gov)

Información sobre artículos sindicados:
URL de origen: https://www.cancer.gov/node/1221851/syndication
Agencia de origen: National Cancer Institute (NCI)
Captured Date: 2022-08-24 19:38:00.0