经肝动脉化疗栓塞术在原发性肝癌治疗中的应用

王辉; 潘裕国; 夏金堂; 周咪咪; 蔡纯

doi:10.3969/j.issn.1001-5256.2018.02.044

经肝动脉化疗栓塞术在原发性肝癌治疗中的应用

DOI: 10.3969/j.issn.1001-5256.2018.02.044

1. 广州医科大学附属第三医院肝胆外科
2. 广州医科大学附属第三医院放射介入科

详细信息

中图分类号: R735.7
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出版历程
- 出版日期: 2018-02-20

Clinical effect of transcatheter arterial chemoembolization in treatment of primary liver cancer: application and research advances

Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Guangzhou Medical University

摘要

摘要:
原发性肝癌是我国第4位常见恶性肿瘤及第3位肿瘤致死病因,目前仅20%的肝癌患者可以行根治性手术切除。许多临床研究证实经肝动脉化疗栓塞术(TACE)在抑制肿瘤生长、复发,提高患者的生存率,改善预后等方面具有良好的效果。从TACE治疗原发性肝癌的适应证以及TACE在肝癌术前的新辅助治疗、肝癌术后的辅助治疗、肝癌术后复发治疗、肝移植前的桥接治疗中的应用等方面进行了综述。
- 肝肿瘤 /
- 化学栓塞,治疗性 /
- 治疗 /
- 综述
Abstract:
Primary liver cancer ranks fourth among the common malignant tumors in China and is the third leading cause of death.At present, only 20% patients with liver cancer are eligible for radical resection.Many clinical studies have confirmed that transcatheter arterial chemoembolization (TACE) has a good effect in inhibiting tumor growth and recurrence and improving patients' survival rate and prognosis.This article reviews the indications for TACE in the treatment of primary liver cancer and its application in preoperative neoadjuvant therapy, postoperative adjuvant therapy, treatment of recurrence after liver cancer surgery, and bridging therapy before liver transplantation.
- liver neoplasms /
- chemoembolization, therapeutic /
- therapy /
- review

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参考文献(39)

[1]Chinese Expert Consensus Statement Chinese Society of Liver Cancer (CSLC) , Chinese Society of Clinical Oncology (CSCO) , Liver Cancer Group, Chinese Society of Hepatology.Consensus on standardized diagnosis and treatment of primary liver cancer[J].J Clin Hepatol, 2009, 25 (2) :83-92. (in Chinese) 中国抗癌协会肝癌专业委员会, 中国抗癌协会临床肿瘤学协作专业委员会, 中华医学会肝病学分会肝癌学组.原发性肝癌规范化诊治的专家共识[J].临床肝胆病杂志, 2009, 25 (2) :83-92.

[2]MA M, NIU TT, SHAO L, et al.Hepatic transcatheter arterial chemoembolization combined with stereotactic radiation therapy of primary liver cancer[J].Trauma Crit Med, 2017, 5 (1) :32-35. (in Chinese) 马明, 牛婷婷, 邵亮, 等.肝动脉化疗栓塞术联合立体定向放疗治疗较大原发性肝癌临床研究[J].创伤与急危重病医学, 2017, 5 (1) :32-35.

[3]National Health and Family Planning Commission of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2017) [J].J Clin Hepatol, 2017, 33 (8) :1419-1431. (in Chinese) 中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范 (2017年版) [J].临床肝胆病杂志, 2017, 33 (8) :1419-1431.

[4]HEIMBACH J, KULIK LM, FINN R, et al.AASLD guidelines for the treatment of hepatocellular carcinoma[J].Hepatology, 2017.[Epub ahead of print]

[5]OMAT AM, LESMANA LA, TATEISHI R, et al.Asian Pacific Association for the Study of the liver consensus recommendations on hepatocellular carcinoma[J].Hepatol Int, 2010, 4 (2) :439-474.

[6]KUDO M, MATSUI O, IZUMI N, et al.JSH consensus-based clinical practice guidelines for the management of hepatocellular carcinoma:2014 update by the liver cancerstudy group of Japan[J].Liver Cancer, 2014, 3 (3-4) :458-468.

[7]European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer.EASL-EORTC clinical practice guidelines:management of hepatocellular carcinoma[J].J Hepatol, 2012, 56 (4) :908-943.

[8]CHOW PK, CHOO SP, NG DC, et al.National cancer centre singapore consensus guidelines for hepatocellular carcinoma[J].Liver Cancer, 2016, 5 (2) :97-106.

[9]Korean Liver Cancer Study Group, National Cancer Center, Korea.2014 Korean liver cancer study group-national cancer center korea practice guideline for the management of hepatocellular carcinoma[J].Korean J Radiol, 2015, 16 (3) :465-522.

[10]ZHONG JH, KE Y, WANG YY, et al.Comparative efficacy of hepatic resection or transarterial chemoembolization for treating intermediate-and advanced-stage hepatocellular carcinoma[J].Chin J Oncol Prev Treat, 2014, 6 (4) :363-370. (in Chinese) 钟鉴宏, 柯阳, 王言焱, 等.巴塞罗那中晚期肝细胞癌肝切除术和经肝动脉化疗栓塞术的疗效分析[J].中国癌症防治杂志, 2014, 6 (4) :363-370.

[11]QI XS, WANG DY, SU CP, et al.Hepatic resection versus transarterial chemoembolization for the initial treatment of hepatocellular carcinoma:a systematic review and meta analysis[J].Oncotarget, 2015, 6 (21) :18715-18733.

[12]ZHANG YF, ZHAO JJ, YAN T, et al.Surgical management and survival analysis of patients with hepatocellular carcinoma beyond BCLC recommendation[J].Int J Clin Exp Med, 2016, 9 (8) :16301-16308.

[13]LAU WY, HO SK, YU SC, et al.Salvage Surgery following downstaging of unresectable hepatocellular carcinoma[J].Ann Surg, 2004, 240 (2) :299-305.

[14]HUANG JF, LI SQ, LIANG LJ.Role and function of transcatheter arterial chemoembolization in treatment of primary liver cancer[J].Chin J Hepatobiliary Surg, 2000, 6 (1) :3-6. (in Chinese) 黄洁夫, 李绍强, 梁力建.肝动脉化疗栓塞在原发性肝癌治疗中的地位和作用[J].中华肝胆外科杂志, 2000, 6 (1) :3-6.

[15]HARADA T, MATSUO K, INOUE T, et al.Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma[J].Ann Surg, 1996, 224 (1) :4-9.

[16]LEI JY, ZHONG JJ, WANG WT, et al.Preoperative transcatheter arterial chemoembolization for resectable hepatocellular carcinoma:a single center analysis[J].Ann Hepatol, 2014, 13 (4) :394-402.

[17]SI T, CHEN Y, MA D, et al.Preoperative transarterial chemoembolization for resectable hepatocellular carcinoma in Asia area:a meta-analysis of random controlled trials[J].Scand J Gastroenterol, 2016, 51 (12) :1512-1519.

[18]LEI JY, ZHONG JJ, YAN LN, et al.Preoperative adjuvant transarterial chemoembolization cannot improve the long term outcome of radical therapies for hepatocellular carcinoma[J].Sci Rep, 2017, 7:41624.

[19]KIM IS, LIM YS, LEE HC, et al.Pre-operative transarterial chemoembolization for resectable hepatocellular carcinoma adversely affects post-operative patient outcome[J].Aliment Pharmacol Ther, 2008, 27 (4) :338-345.

[20]SHI HY, WANG SN, WANG SC, et al.Preoperative transarterial chemoembolization and resection for hepatocellular carcinoma:a nationwide Taiwan database analysis of long term outcome predictors[J].J Surg Oncol, 2014, 109 (5) :487-493.

[21]CHENG HY, XU W, XU AM, et al.Evaluation of transcathater arterial chemoembolization in the prevention of postoperative recurrence in 1630 patients with hepatocellular carcinoma[J].Chin J Oncol, 2005, 27 (10) :626-628. (in Chinese) 程红岩, 徐雯, 徐爱民, 等.肝动脉插管化疗栓塞在预防肝癌术后复发中的应用价值[J].中华肿瘤杂志, 2005, 27 (10) :626-628.

[22]LIU PF, LIU RH, XU H, et al.Significance of preventive TACE in primary liver cancer after operation[J].Chin J Hepatobiliary Surg, 2015, 11 (2) :81-82.刘鹏飞, 刘荣华, 徐荷, 等.原发性肝癌术后预防性TACE的意义 (附433例病例随访) [J].中华肝胆外科杂志, 2015, 11 (2) :81-82.

[23]ZHAO Y, LIU CK, ZHANG Q.et al.Retrospective analysis of TACE times after primary liver cancer operation[J].Ann Hepatol, 2014, 13 (4) :394-402.

[24]LIAO M, ZHU Z, WANG H, et al.Adjuvant transarterial chemoembolization for patients after curative resection of hepatocellular carcinoma:a meta-analysis[J].Scand J Gastroenterol, 2017, 52 (6-7) :624-634.

[25]QI X, LIU L, WANG D, et al.Hepatic resection alone versus in combination with pre-and post-operative transarterial chemoembolization for the treatment of hepatocellular c-arcinoma:a systematic review and meta-analysis[J].Oncotarget, 2015, 6 (34) :36838-36859.

[26]WU MC.Current status and perspectives of comprehensive surgical treatment of primary liver cancer[J].Chin J Surg, 2004, 42 (1) :13-15. (in Chinese) 吴孟超.原发性肝癌外科综合治疗的现状和展望[J].中华外科杂志, 2004, 42 (1) :13-15.

[27]CHEN L, ZHANG ZW, CHEN YF, et al.The comprehensive treatment for 293 cases of postoperative recurrent of primary hepatocellular carcinoma[J].J Abdominal Surg, 2017, 30 (2) :89-92, 96. (in Chinese) 陈琳, 张志伟, 陈义发, 等.293例原发性肝癌术后复发的综合治疗效果分析[J].腹部外科, 2017, 30 (2) :89-92, 96.

[28]WANG DY, LIU L, QI XS, et al.Hepatic re-resection versus transarterial chemoembolization for the treatment of recurrent hepatocellular carcinoma after initial resection:a systematic review and meta-analysis[J].Asian Pac J Cancer Prev, 2015, 16 (13) :5573-7558.

[29]YANG Y, ZHANG YC.Thinking about the future direction of liver transplantation for liver cancer[J].Chin J Organ Transplat, 2016, 7 (1) :1-7. (in Chinese) 杨扬, 张英才.肝癌肝移植未来方向的思考[J].器官移植, 2016, 7 (1) :1-7.

[30]MADDALA YK, STADHEIM L, ANDREWS JC, et al.Drop-out rates of patients with hepatocellular cancer listed for liver transplantation:outcome with chemoembolization[J].Liver Transpl, 2004, 10 (3) :449-455.

[31]FUJIKI M, AUCEJO F, KIM R.General overview of neo-adjuvant therapy for hepat-ocellular carcinoma before liver transplantation:necessity or option?[J].Liver Int, 2011, 31 (8) :1081-1089.

[32]BENSON AB, BURTON JR jr, AUSTIN GL, et al.Differential effects of plasma and red blood cell transfusions on acute lung injury and infection risk following liver transplantation[J].Liver Transpl, 2011, 17 (2) :149-158.

[33]NICOLINI D, SVEGLIATI-BARONI G, CANDELARI R, et al.Doxorubicin-eluting bead vs conventional transcatheter arterial chemoembolization for hepatocellular carcinoma before liver transplantation[J].World J Gastroenterol, 2013, 19 (34) :5622-5632.

[34]DAI M, ZHOU J, CUI ZL, et al.Long-term outcomes of transcatheter arterial chemoembolization before liver transplantation in patients with hepatocellular carcinoma[J].J South Med Univ, 2014, 34 (8) :1145-1148. (in Chinese) 戴敏, 周杰, 崔忠林, 等.肝移植前行肝动脉介入栓塞化疗的远期效果分析[J].南方医科大学学报, 2014, 34 (8) :1145-1148.

[35]FENG YL, ZHAO LB, WANG XH, et al.Clinical evaluation of interventional therapy in patients with advanced hepatocellular carcinoma before transplantation[J].J Intervent Radiol, 2007, 16 (7) :464-467. (in Chinese) 冯耀良, 赵林波, 王学浩, 等.中晚期肝癌肝移植术前介入治疗的临床价值[J].介入放射学杂志, 2007, 16 (7) :464-467.

[36]MAJNO PE, ADAM R, BISMUTH H, et al.Influence of preoperative transarterial lipiodol chemoembolization on resection and transplantation for hepatocellular carcinoma in patients with cirrhosis[J].Ann Surg, 1997, 226 (6) :688-701.

[37]ALBA E, VALLS C, DOMINGUEZ J, et al.Transcatheter arterial chemoembolization in patients with hepatocellular carcinoma on the waiting list for orthotopic liver transplantation[J].AJR Am J Roentgenol, 2008, 190 (5) :1341-1348.

[38]DECAENS T, ROUDOT-THORAVAL F, BRESSON-HADNI S, et al.Impact of pretr-ansplantation transarterial chemoembolization on survival and recurrence after liver transpla-ntation for hepatocellular carcinoma[J].Liver Transpl, 2005, 11 (7) :767-775.

[39]PEREZ SABORIDO B, MENEU JC, MORENO E, et al.Is transarterial chemoembol-ization necessary before liver transplantation for hepatocellular carcinoma?[J].Am J Surg, 2005, 190 (3) :383-387.

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