Liver and Other Neoplasms - Treatment Approaches

PEI is medically necessary for hepatocellular carcinoma (HCC) without extra‑hepatic spread; CE/TACE is medically necessary for unresectable primary HCC, liver‑only metastases from uveal (ocular) melanoma, as a pre‑operative bridge to orthotopic liver transplant for HCC, and for neuroendocrine liver tumors (carcinoid and pancreatic endocrine tumors) — with CE for carcinoid covered only after failure of systemic octreotide to control carcinoid syndrome. Chemoembolization for other non‑neuroendocrine primaries (e.g., breast, cervical, colon, esophageal, melanoma, rhabdomyosarcoma, unknown primaries) and pancreatic CE, DEB‑TACE for leiomyosarcoma/colorectal mets or primary liver‑dominant disease, electro‑chemotherapy, electro‑coagulation, and dendritic/cytokine‑induced killer cell immunotherapy for HCC are considered experimental/investigational and excluded.

"When using SIR-Spheres, documentation of absence of recent capecitabine exposure (no capecitabine within past 2 months) and no planned capecitabine after treatment, or other documented contraindica..."