肝细胞癌的介入治疗

摘要/Abstract

摘要： 肝细胞癌(HCC)在全球范围内发病率逐年上升,已成为肿瘤相关致死原因第4位。影像引导介入治疗在HCC的治疗中发挥着主要作用。射频消融(RFA)是HCC早期的重要治疗手段,经动脉化疗栓塞(TACE)是中期HCC的标准治疗。其他局部消融技术如:微波消融(WMA)、冷冻消融(CRYO)和不可逆电穿孔(IRE)及经动脉治疗如:经动脉栓塞(TAE)、药物洗脱微球经动脉化疗栓塞(DTACE)、肝动脉灌注化疗(HAIC)和选择性内放射治疗(SIRT)也已得到广泛应用。我们总结了HCC介入治疗的研究成果,探讨患者选择和治疗决策的优化,分析联合全身治疗的方案及预期效果,并展望了未来探索方向,明确介入治疗在HCC治疗中的重要地位。

杨柏帅, 袁敏. 肝细胞癌的介入治疗[J]. 肝脏, 2023, 28(3): 279-280.

参考文献

[1] Llovet JM, De Baere T, Kulik L, et al. Locoregional therapies in the era of molecular and immune treatments for hepatocellular carcinoma. Nat Rev Gastroenterol Hepatol,2021,18:293-313.
[2] Cassinotto C, Nogue E, Morell M, et al. Changing trends in hepatocellular carcinoma management: results from a nation wide database in the last decade. Eur J Cancer,2021,146:48-55.
[3] de Baere T, Tselikas L, Deschamps F, et al. Advances in transarterial therapies for hepatocellular carcinoma: is novel technology leading to better outcomes? Hepat Oncol,2016,3:109-118.
[4] Vitale A, Trevisani F, Farinati F, et al. Treatment of hepatocellular carcinoma in the precision medicine era: from treatment stage migration to therapeutic hierarchy. Hepatology,2020,72:2206-2218.
[5] Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol,2022,76(3):681-693.
[6] Salem R, Gabr A, Riaz A, et al. Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000-patient 15-year experience. Hepatology,2018,68:1429-1440.
[7] Takayama T, Hasegawa K, Izumi N, et al. Surgery versus Radiofrequency Ablation for Small Hepatocellular Carcinoma: A Randomized Controlled Trial (SURF Trial). Liver Cancer,2021,11(3):209-218.
[8] Zhang YJ, Chen MS, Chen Y, et al. Long-term Outcomes of Transcatheter Arterial Chemoembolization Combined With Radiofrequency Ablation as an Initial Treatment for Early-Stage Hepatocellular Carcinoma. JAMA Netw Open,2021,4(9):e2126992.
[9] Salem R, Tselikas L, De Baere T. Interventional treatment of hepatocellular carcinoma. J Hepatol,2022,77(4):1205-1206.
[10] Salem R, Gordon AC, Mouli S, et al. Y90 radioembolization significantly prolongs time to progression compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology,2016,151:1155-1163 e1152.
[11] Li QJ, He MK, Chen HW, et al. Hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin versus transarterial chemoembolization for large hepatocellular carcinoma: a randomized phase III trial. J Clin Oncol,2022,40:150-160.
[12] Kudo M, Ueshima K, Ikeda M, et al. Randomised, multicentre prospective trial of transarterial chemoembolisation (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma: TACTICS trial. Gut,2020,69(8):1492-1501.
[13] Palmer DH, Malagari K, Kulik LM. Role of locoregional therapies in the wake of systemic therapy. J Hepatol,2020,72:277-287.
[14] Lyu N, Wang X, Li JB, et al. Arterial chemotherapy of oxaliplatin plus fluorouracil versus sorafenib in advanced hepatocellular carcinoma: a biomolecular exploratory, randomized, phase III trial (FOHAIC-1). J Clin Oncol,2022,40:468-480.
[15] Garin E, Palard X, Rolland Y. Personalised Dosimetry in Radioembolisation for HCC: Impact on Clinical Outcome and on Trial Design. Cancers (Basel),2020,12(6):1557.
[16] Peng Z, Fan W, Zhu B, et al. Lenvatinib Combined With Transarterial Chemoembolization as First-Line Treatment for Advanced Hepatocellular Carcinoma: A Phase III, Randomized Clinical Trial (LAUNCH). J Clin Oncol,2023,41(1):117-127.
[17] Tselikas L, Champiat S, Sheth RA, et al. Interventional Radiology for local immunotherapy in oncology. Clin Cancer Res,2021,27:2698-2705.