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肝细胞癌放疗降期——从姑息走向根治

曾昭冲 孙建国 郎锦义

引用本文:
Citation:

肝细胞癌放疗降期——从姑息走向根治

DOI: 10.3969/j.issn.1001-5256.2020.02.003
基金项目: 

国家重点研发计划专项资助(2017YFC0112100) 

详细信息
  • 中图分类号: R735.7

Radiotherapy for hepatocellular carcinoma downstaging: From palliative care to radical treatment

Research funding: 

 

  • 摘要:

    肿瘤分期是为了指导按分期治疗,某一期别的治疗方案不是一成不变的,应根据病情变化适时调整,尽可能朝有利疾病控制的方向转化。肝癌治疗进程需要随访和再分期,目的是为患者创造更好的治疗方案,特别是根治机会。局限肝内的大肝癌不能手术切除,经过介入栓塞化疗结合放疗,肿瘤缩小降期,部分转化为可手术切除,从不可治愈转化为可治愈。伴有门静脉癌栓的肝癌患者,经过新辅助放疗,癌栓缩小后再予手术切除,生存期较未新辅助放疗者显著延长。大肝癌经过综合治疗后降期为小肝癌,转化为立体定向放疗或射频消融,也可从姑息走向根治。肝癌放疗降期的临床报道渐多,循证级别逐渐提高,值得在临床实践中借鉴。

     

  • [1] ZENG ZC,TANG ZY,YANG BH,et al. Comparison between radioimmunotherapy and external beam radiation therapy for patients with hepatocellular carcinoma[J]. Eur J Nucl Med,2002,29(12):1657-1668.
    [2] ZENG ZC,TANG ZY,ZHOU J,et al. A comparison of chemoembolization combination with and without radiotherapy for unresectable hepatocellular carcinoma[J]. Cancer J,2004,10(5):307-316.
    [3] KAMIYAMA T,NAKANISHI K,YOKOO H,et al. Efficacy of preoperative radiotherapy to portal vein tumor thrombus in the main trunk or first branch in patients with hepatocellular carcinoma[J]. Int J Clin Oncol,2007,12(5):363-368.
    [4] WEI X,JIANG Y,ZHANG X,et al. Neoadjuvant three-dimensional conformal radiotherapy for resectable hepatocellular carcinoma with portal vein tumor thrombus:A randomized,open-label,multicenter controlled study[J]. J Clin Oncol,2019,37(24):2141-2151.
    [5] KIM J,LEE I,KIM J,et al. Clinical features of hepatocellular carcinoma patients undergoing resection after concurrent chemoradiation therapy[J]. Int J Radiat Oncol Biol Phys,2012,84(Suppl 3):s336-s337.
    [6] WIGG A,HON K,MOSEL L,et al. Down-staging of hepatocellular carcinoma via external-beam radiotherapy with subsequent liver transplantation:A case report[J]. Liver Transpl,2013,19(10):1119-1124.
    [7] JEONG Y,SHIN MH,YOON SM,et al. Liver transplantation after transarterial chemoembolization and radiotherapy for hepatocellular carcinoma with vascular invasion[J]. J Gastrointest Surg,2017,21(2):275-283.
    [8] CHOI JY,YU JI,PARK HC,et al. The possibility of radiotherapy as downstaging to living donor liver transplantation for hepatocellular carcinoma with portal vein tumor thrombus[J].Liver Transpl,2017,23(4):545-551.
    [9] KATZ AW,CHAWLA S,QU ZH,et al. Stereotactic hypofractionated radiation therapy as a bridge to transplantation for hepatocellular carcinoma:Clinical outcome and pathologic correlation[J]. Int J Radiat Oncol Biol Phys,2012,83(3):895-900.
    [10] O’CONNOR JK,TROTTER J,DAVIS GL,et al. Long-term outcomes of stereotactic body radiation therapy in the treatment of hepatocellular cancer as a bridge to transplantation[J]. Liver Transpl,2012,18(8):949-954.
    [11] SAPISOCHIN G,BARRY A,DOHERTY M,et al. Stereotactic body radiotherapy vs. TACE or RFA as a bridge to transplant in patients with hepatocellular carcinoma. An intention-totreat analysis[J]. J Hepatol,2017,67(1):92-99.
    [12] BUSH DA,SMITH JC,SLATER JD,et al. Randomized clinical trial comparing proton beam radiation therapy with transarterial chemoembolization for hepatocellular carcinoma:Results of an interim analysis[J]. Int J Radiat Oncol Biol Phys,2016,95(1):477-482.
    [13] WONG TC,CHIANG CL,LEE AS,et al. Better survival after stereotactic body radiation therapy following transarterial chemoembolization in nonresectable hepatocellular carcinoma:A propensity score matched analysis[J]. Surg Oncol,2019,28:228-235.
    [14] Chinese Society of Liver Cancer,Chinese Medical Doctor Association. Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus(2018)[J]. J Clin Hepatol,2019,35(4):737-743.(in Chinese)中国医师协会肝癌专业委员会.肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2018年版)[J].临床肝胆病杂志,2019,35(4):737-743.
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  • 收稿日期:  2019-10-08
  • 出版日期:  2020-02-20
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