PDF下载 ( 1976 KB)
Role of interventional therapy in the downstaging of advanced liver cancer
-
摘要:
介入治疗已成为中晚期肝癌姑息治疗的主力军。与此同时,在肝癌降期领域,介入治疗也发挥着越来越重要的作用,通过局部介入治疗可使中晚期肝癌的瘤灶体积减小、数量减小使之符合肝癌移植或者切除术标准。介入降期技术包括经肝动脉化疗栓塞术、药物缓释微球、经动脉放射性栓塞治疗以及各种消融治疗技术(射频消融、微波消融、冷冻消融、酒精消融)等。最佳的介入降期策略仍未达成共识,但是通过开展高级别循证医学研究,对不同方法的最佳可获益人群进行筛选,评估不同介入降期策略对后续肝移植手术在手术难度、安全性、术后疗效等方面的影响,有望提升介入治疗在中晚期肝癌降期的效果。
Abstract:Interventional therapy has become an important palliative therapy for advanced liver cancer,and meanwhile,interventional therapy is playing an important role in the downstaging of liver cancer. Local interventional therapy can help patients meet the criteria for transplantation or resection by reducing tumor volume and number in patients with advanced liver cancer. Interventional downstaging techniques include transarterial chemotherapy,drug-eluting beads,transarterial radioembolization,and various ablation techniques( radiofrequency ablation,microwave ablation,cryoablation,and ethanol ablation). No consensus has been reached on the optimal interventional downstaging strategy,while high-level evidence-based clinical studies are needed to screen out the optimal candidates for different methods and evaluate the complexity,safety,and long-term efficacy of subsequent liver transplantation after interventional downstaging therapy,so as to improve the effect of interventional therapy in the downstaging of advanced liver cancer.
-
Key words:
- liver neoplasms /
- chemoembolization,therapeutic /
- local ablation
-
[1] BRAY F,FERLAY J,SOERJOMATARAM I,et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2018,68(6):394-424. [2] ZHOU J,SUN HC,WANG Z,et al. Guidelines for diagnosis and treatment of primary liver cancer in china(2017 edition)[J]. Liver cancer,2018,7(3):235-260. [3] KULIK L,HEIMBACH JK,ZAIEM F,et al. Therapies for patients with hepatocellular carcinoma awaiting liver transplantation:A systematic review and meta-analysis[J]. Hepatology,2018,67(1):381-400. [4] MARRERO JA,KULIK LM,SIRLIN CB,et al. Diagnosis,staging, and management of hepatocellular carcinoma:2018practice guidance by the American Association for the Study of Liver Diseases[J]. Hepatology,2018,68(2):723-750. [5] RAVAIOLI M,ODALDI F,CUCCHETTI A,et al. Long term results of down-staging and liver transplantation for patients with hepatocellular carcinoma beyond the conventional criteria[J]. Sci Rep,2019,9(1):3781. [6] PARIKH ND,WALJEE AK,SINGAL AG. Downstaging hepatocellular carcinoma:A systematic review and pooled analysis[J]. Liver Transpl,2015,21(9):1142-1152. [7] BARAKAT O,WOOD RP,OZAKI CF,et al. Morphological features of advanced hepatocellular carcinoma as a predictor of downstaging and liver transplantation:An intention-totreat analysis[J]. Liver Transpl,2010,16(3):289-299. [8] CESCON M,CUCCHETTI A,RAVAIOLI M,et al. Hepatocellular carcinoma locoregional therapies for patients in the waiting list. Impact on transplantability and recurrence rate[J]. J Hepatol,2013,58(3):609-618. [9] BHARAT A,BROWN DB,CRIPPIN JS,et al. Pre-liver transplantation locoregional adjuvant therapy for hepatocellular carcinoma as a strategy to improve longterm survival[J]. J Am Coll Surg,2006,203(4):411-420. [10] YAO FY,KINKHABWALA M,LABERGE JM,et al. The impact of pre-operative loco-regional therapy on outcome after liver transplantation for hepatocellular carcinoma[J]. Am J Transplant,2005,5(4 Pt 1):795-804. [11] WERNER JD,FRANGAKIS C,RUCK JM,et al. Neoadjuvant transarterial chemoembolization improves survival after liver transplant in patients with hepatocellular carcinoma[J]. Exp Clin Transplant,2019,17(5):638-643. [12] LI HL,JI WB,ZHAO R,et al. Poor prognosis for hepatocellular carcinoma with transarterial chemoembolization pre-transplantation:Retrospective analysis[J]. World J Gastroenterol,2015,21(12):3599-3606. [13] SEEHOFER D,NEBRIG M,DENECKE T,et al. Impact of neoadjuvant transarterial chemoembolization on tumor recurrence and patient survival after liver transplantation for hepatocellular carcinoma:A retrospective analysis[J]. Clin Transplant,2012,26(5):764-774. [14] LAMMER J,MALAGARI K,VOGL T,et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma:Results of the PRECISION V study[J]. Cardiovasc Intervent Radiol,2010,33(1):41-52. [15] FRENETTE CT,OSORIO RC,STARK J,et al. Conventional TACE and drug-eluting bead TACE as locoregional therapy before orthotopic liver transplantation:Comparison of explant pathologic response[J]. Transplantation,2014,98(7):781-787. [16] LEE BH,LEE DS,CHO CW,et al. Role and limitation of neoadjuvant hepatic arterial infusion chemotherapy in advanced hepatocelluar carcinoma patients with Child-Pugh class A[J]. World J Surg Oncol,2019,17(1):143. [17] LOBO L,YAKOUB D,PICADO O,et al. Unresectable hepatocellular carcinoma:Radioembolization versus chemoembolization:A systematic review and meta-analysis[J]. Cardiovasc Intervent Radiol,2016,39(11):1580-1588. [18] SALEM R,GILBERTSEN M,BUTT Z,et al. Increased quality of life among hepatocellular carcinoma patients treated with radioembolization,compared with chemoembolization[J]. Clin Gastroenterol Hepatol,2013,11(10):1358-1365. [19] SALEM R,GORDON AC,MOULI S,et al. Y90 radioembolization significantly prolongs time to progression compared with chemoembolization in patients with hepatocellular carcinoma[J]. Gastroenterology,2016,151(6):1155-1163. [20] LEWANDOWSKI RJ,KULIK LM,RIAZ A,et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma:Chemoembolization versus radioembolization[J]. Am J Transplant,2009,9(8):1920-1928. [21] MOHAMED M,KATZ AW,TEJANI MA,et al. Comparison of outcomes between SBRT, yttrium-90 radioembolization,transarterial chemoembolization,and radiofrequency ablation as bridge to transplant for hepatocellular carcinoma[J]. Adv Radiat Oncol,2015,1(1):35-42. [22] PARDO F,SANGRO B,LEE RC,et al. The Post-SIRSpheres Surgery Study(P4S):Retrospective analysis of safety following hepatic resection or transplantation in patients previously treated with selective internal radiation therapy with yttrium-90 resin microspheres[J]. Ann Surg Oncol,2017,24(9):2465-2473. [23] GABR A,ABOUCHALEH N,ALI R,et al. Comparative study of post-transplant outcomes in hepatocellular carcinoma patients treated with chemoembolization or radioembolization[J]. Eur J Radiol,2017,93:100-106. [24] PADIA SA,JOHNSON GE,HORTON KJ,et al. Segmental yttrium-90 radioembolization versus segmental chemoembolization for localized hepatocellular carcinoma:Results of a single-center,retrospective,propensity score-matched study[J]. J Vasc Interv Radiol,2017,28(6):777-785. [25] BIEDERMAN DM,TITANO JJ,KORFF RA,et al. Radiation segmentectomy versus selective chemoembolization in the treatment of early-stage hepatocellular carcinoma[J]. J Vasc Interv Radiol,2018,29(1):30-37. [26] LEWANDOWSKI RJ,DONAHUE L,CHOKECHANACHAISAKUL A,et al.(90)Y radiation lobectomy:Outcomes fol owing surgical resection in patients with hepatic tumors and small future liver remnant volumes[J]. J Surg Oncol,2016,114(1):99-105. [27] RUDNICK SR,RUSSO MW. Liver transplantation beyond or downstaging within the Milan criteria for hepatocellular carcinoma[J]. Expert Rev Gastroenterol Hepatol,2018,12(3):265-275. [28] KULIK L,VOUCHE M,KOPPE S,et al. Prospective randomized pilot study of Y90+/-sorafenib as bridge to transplantation in hepatocellular carcinoma[J]. J Hepatol,2014,61(2):309-317. [29] CHOW PKH,GANDHI M,TAN SB,et al. SIRveNIB:Selective internal radiation therapy versus sorafenib in Asia-Pacific patients with hepatocellular carcinoma[J]. J Clin Oncol,2018,36(19):1913-1921. [30] VILGRAIN V,PEREIRA H,ASSENAT E,et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma(SARAH):An open-label randomised controlled phase 3 trial[J]. Lancet Oncol,2017,18(12):1624-1636. [31] KENNEDY A,BROWN DB,FEILCHENFELDT J,et al. Safety of selective internal radiation therapy(SIRT)with yttrium-90microspheres combined with systemic anticancer agents:Expert consensus[J]. J Gastrointest Oncol,2017,8(6):1079-1099. [32] SALMAN A,SIMONEAU E,HASSANAIN M,et al. Combined sorafenib and yttrium-90 radioembolization for the treatment of advanced hepatocellular carcinoma[J]. Curr Oncol,2016,23(5):e472-e480. [33] SHIINA S,TAGAWA K,NIWA Y,et al. Percutaneous ethanol injection therapy for hepatocellular carcinoma:Results in 146patients[J]. AJR Am J Roentgenol,1993,160(5):1023-1028. [34] SHIINA S,TAGAWA K,UNUMA T,et al. Percutaneous ethanol injection therapy of hepatocellular carcinoma:Analysis of77 patients[J]. AJR Am J Roentgenol,1990,155(6):1221-1226. [35] LLOVET JM,MAS X,APONTE JJ,et al. Cost effectiveness of adjuvant therapy for hepatocellular carcinoma during the waiting list for liver transplantation[J]. Gut,2002,50(1):123-128. [36] POMPILI M,MIRANTE VG,RONDINARA G,et al. Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation:Assessment of efficacy at explant analysis and of safety for tumor recurrence[J]. Liver Transpl,2005,11(9):1117-1126. [37] YAO FY,HIROSE R,LABERGE JM,et al. A prospective study on downstaging of hepatocellular carcinoma prior to liver transplantation[J]. Liver Transpl,2005,11(12):1505-1514. [38] LENCIONI RA,ALLGAIER HP,CIONI D,et al. Small hepatocellular carcinoma in cirrhosis:Randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection[J]. Radiology,2003,228(1):235-240. [39] SHIINA S,TERATANI T,OBI S,et al. A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma[J]. Gastroenterology,2005,129(1):122-130. [40] FENG K,YAN J,LI X,et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma[J]. J Hepatol,2012,57(4):794-802. [41] FISHER RA,MALUF D,COTTERELL AH,et al. Non-resective ablation therapy for hepatocellular carcinoma:Effectiveness measured by intention-to-treat and dropout from liver transplant waiting list[J]. Clin Transplant,2004,18(5):502-512. [42] FONTANA RJ,HAMIDULLAH H,NGHIEM H,et al. Percutaneous radiofrequency thermal ablation of hepatocellular carcinoma:A safe and effective bridge to liver transplantation[J].Liver Transpl,2002,8(12):1165-1174. [43] MAZZAFERRO V,BATTISTON C,PERRONE S,et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation:A prospective study[J]. Ann Surg,2004,240(5):900-909. [44] LU DS,YU NC,RAMAN SS,et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation[J]. Hepatology,2005,41(5):1130-1137. [45] HINSHAW JL,LUBNER MG,ZIEMLEWICZ TJ,et al. Percutaneous tumor ablation tools:Microwave,radiofrequency,or cryoablation-what should you use and why?[J]. Radiographics,2014,34(5):1344-1362. [46] POULOU LS,BOTSA E,THANOU I,et al. Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma[J]. World J Hepatol,2015,7(8):1054-1063. [47] PILLAI K,AKHTER J,CHUA TC,et al. Heat sink effect on tumor ablation characteristics as observed in monopolar radiofrequency,bipolar radiofrequency,and microwave,using ex vivo calf liver model[J]. Medicine(Baltimore),2015,94(9):e580. [48] SHIBATA T,IIMURO Y,YAMAMOTO Y,et al. Small hepatocellular carcinoma:Comparison of radio-frequency ablation and percutaneous microwave coagulation therapy[J]. Radiology,2002,223(2):331-337. [49] VIETTI VIOLI N,DURAN R,GUIU B,et al. Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease:A randomised controlled phase 2 trial[J]. Lancet Gastroenterol Hepatol,2018,3(5):317-325. [50] CHARPENTIER KP,WOLF F,NOBLE L,et al. Irreversible electroporation of the liver and liver hilum in swine[J]. HPB(Oxford),2011,13(3):168-173. [51] PHILLIPS MA,NARAYAN R,PADATH T,et al. Irreversible electroporation on the small intestine[J]. Br J Cancer,2012,106(3):490-495. [52] SUTTER O,CALVO J,N’KONTCHOU G,et al. Safety and efficacy of irreversible electroporation for the treatment of hepatocellular carcinoma not amenable to thermal ablation techniques:A retrospective single-center case series[J]. Radiology,2017,284(3):877-886. [53] BHUTIANI N,PHILIPS P,SCOGGINS CR,et al. Evaluation of tolerability and efficacy of irreversible electroporation(IRE)in treatment of Child-Pugh B(7/8)hepatocellular carcinoma(HCC)[J]. HPB(Oxford),2016,18(7):593-599. [54] WANG C,WANG H,YANG W,et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma[J]. Hepatology,2015,61(5):1579-1590. [55] WU S,HOU J,DING Y,et al. Cryoablation versus radiofrequency ablation for hepatic malignancies:A systematic review and literature-based analysis[J]. Medicine(Baltimore),2015,94(49):e2252. [56] SEIFERT JK,MORRIS DL. World survey on the complications of hepatic and prostate cryotherapy[J]. World J Surg,1999,23(2):109-113. [57] RONG G,BAI W,DONG Z,et al. Long-term outcomes of percutaneous cryoablation for patients with hepatocellular carcinoma within Milan criteria[J]. PLo S One,2015,10(4):e0123065. [58] SHI F,WU M,LIAN SS,et al. Radiofrequency ablation following downstaging of hepatocellular carcinoma by using transarterial chemoembolization:Long-term outcomes[J]. Radiology,2019,293(3):707-715. -
本文二维码
计量
- 文章访问数: 1052
- HTML全文浏览量: 17
- PDF下载量: 279
- 被引次数: 0
下载:
