射频消融治疗肝细胞癌的研究进展

罗丹东; 乔安意

doi:10.3969/j.issn.1001-5256.2017.07.034

射频消融治疗肝细胞癌的研究进展

DOI: 10.3969/j.issn.1001-5256.2017.07.034

广州医科大学附属第三医院肝胆外科

详细信息

中图分类号: R735.7
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- 文章访问数: 1934
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- 被引次数: 21
出版历程
- 收稿日期: 2017-01-05
- 出版日期: 2017-07-20

Research advances in radiofrequency ablation in treatment of hepatocellular carcinoma

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

摘要

摘要: 肝细胞癌是世界上癌症相关致死最常见的原因之一,仅20%的肝细胞癌患者可以行根治性治疗。许多临床研究证实射频消融可提供良好的局部控制,且安全性高,可作为根治性手术的替代。从射频消融治疗肝细胞癌的适应证、疗效及其与根治性手术切除和经肝动脉化疗栓塞术治疗效果的比较等方面进行了综述,认为需按照患者的个体化情况选择合适的治疗方案。
- 癌,肝细胞 /
- 导管消融术 /
- 治疗 /
- 综述
Abstract: Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death in the world, and only 20% of HCC patients can undergo radical treatment.Radiofrequency ablation induces coagulative necrosis of cells via thermal energy, kills tumor cells, and makes it possible to cure HCC.Many clinical studies have confirmed that radiofrequency ablation provides good local control and has high safety, and therefore, it can be used to replace radical surgery.This article reviews the indications and therapeutic effect of radiofrequency ablation in the treatment of HCC, as well as its comparison with radical surgical resection and transarterial chemoembolization in terms of their therapeutic effects.It is pointed out that the treatment regimen should be selected based on the patient's individualized conditions.
- carcinoma, hepatocellular /
- catheter ablation /
- therapy /
- review

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参考文献(32)

[1]BRUIX J, REIG M, SHERMAN M.Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma[J].Gastroenterology, 2016, 150 (4) :835-853.

[2]CHEN WQ, ZHENG RS, ZHANG SW, et al.Report of cancer incidence and mortality in China, 2012[J].China Cancer, 2016, 25 (1) :1-8. (in Chinese) 陈万青, 郑荣寿, 张思维, 等.2012年中国恶性肿瘤发病和死亡分析[J].中国肿瘤, 2016, 25 (1) :1-8.

[3]YAN LB, TANG H.Progression and prospect in the diagnosis and treatment of chronic hepatitis B[J].Pract J Clin Med, 2016, 13 (2) :5-9. (in Chinese) 严丽波, 唐红.慢性乙型肝炎诊治进展和展望[J].实用医院临床杂志, 2016, 13 (2) :5-9.

[4]ZHAO RR, DENG YD, YUAN H.Epidemiological and clinical features of primary liver cancer:an analysis of 236 patients[J].J Clin Hepatol, 2016, 32 (8) :1538-1542. (in Chinese) 赵荣荣, 邓永东, 袁宏.236例原发性肝癌患者流行病学及临床特点分析[J].临床肝胆病杂志, 2016, 32 (8) :1538-1542.

[5]ZHANG YB, HONG DF, HUANG DS, et al.Percutaneous microwave or radiofrequency ablation liver partition and portal vein embolization for planned hepatectomy[J].Chin J Dig Surg, 2016, 15 (5) :510-514. (in Chinese) 张远标, 洪德飞, 黄东胜, 等.经皮微波或射频消融肝实质分隔联合门静脉栓塞计划性肝切除术治疗肝硬化肝癌[J].中华消化外科杂志, 2016, 15 (5) :510-514.

[6]ZHU XL, SHEN J.Application of local ablative therapies for hepatocellular carcinoma[J].J Clin Hepatol, 2016, 32 (1) :56-61. (in Chinese) 朱晓黎, 沈健.局部消融在肝细胞癌治疗中的应用[J].临床肝胆病杂志, 2016, 32 (1) :56-61.

[7]ZHANG Y, YANG W.The bridging therapy of hepatocellular carcinoma before liver transplantation[J].J Minim Invas Med, 2014, 9 (6) :763-765. (in Chinese) 张玉, 杨炜.原发性肝癌行肝移植前的桥接治疗[J].微创医学, 2014, 9 (6) :763-765.

[8]OMATA M, 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.

[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]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.

[11]KOKUDO N, HASEGAWA K, AKAHANE M, et al.Evidencebased Clinical Practice Guidelines for Hepatocellular Carcinoma:The Japan Society of Hepatology 2013 update (3rd JSH-HCCGuidelines) [J].Hepatol Res, 2015, 45 (2) :123-127.

[12]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.

[13]LEE DH, LEE JM, LEE JY, et al.Radiofrequency ablation for intrahepatic recurrent hepatocellular carcinoma:long-term results and prognostic factors in 168 patients with cirrhosis[J].Cardiovasc Intervent Radiol, 2014, 37 (3) :705-715.

[14]CAI H, KONG W, ZHOU T, et al.Radiofrequency ablation versus reresection in treating recurrent hepatocellular carcinoma:a metaanalysis[J].Medicine (Baltimore) , 2014, 93 (22) :e122.

[15]YIN XY, XIE XY, LU MD, et al.Percutaneous thermal ablation of medium and large hepatocellular carcinoma:long-term outcome and prognostic factors[J].Cancer, 2009, 115 (9) :1914-1923.

[16]YIN X, ZHANG L, WANG YH, et al.Transcatheter arterial chemoembolization combined with radiofrequency ablation delays tumor progression and prolongs overall survival in patients with intermediate (BCLCB) hepatocellular carcinoma[J].BMC Cancer, 2014, 14:849.

[17]ROSSI S, di STASI M, BUSCARINI E, et al.Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer[J].AJR Am J Roentgenol, 1996, 167 (3) :759-768.

[18]LIVRAGHI T, MELONI F, di STASI M, et al.Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis:Is resection still the treatment of choice?[J].Hepatology, 2008, 47 (1) :82-89.

[19]SHIINA S, TATEISHI R, ARANO T, et al.Radiofrequency ablation for hepatocellular carcinoma:10-year outcome and prognostic factors[J].Am J Gastroenterol, 2012, 107 (4) :569-577.

[20]FRANCICA G, SAVIANO A, de SIO I, et al.Long-term effectiveness of radiofrequency ablation for solitary small hepatocellular carcinoma:a retrospective analysis of 363 patients[J].Dig Liver Dis, 2013, 45 (4) :336-341.

[21]KIM GA, SHIM JH, KIM MJ, et al.Radiofrequency ablation as an alternative to hepatic resection for single small hepatocellular carcinomas[J].Br J Surg, 2016, 103 (1) :126-135.

[22]JIANG L, YAN L, WEN T, et al.Comparison of outcomes of hepatic resection and radiofrequency ablation for hepatocellular carcinoma patients with multifocal tumors meeting the Barcelona-Clinic Liver Cancer stage A classification[J].J Am Coll Surg, 2015, 221 (5) :951-961.

[23]SONG J, WANG Y, MA K, et al.Laparoscopic hepatectomy versus radiofrequency ablation for minimally invasive treatment of single, small hepatocellular carcinomas[J].Surg Endosc, 2016, 30 (10) :4249-4257.

[24]GORY I, FINK M, BELL S, et al.Radiofrequency ablation versus resection for the treatment of early stage hepatocellular carcinoma:a multicenter Australian study[J].Scand J Gastroenterol, 2015, 50 (5) :567-576.

[25]FENG Q, CHI Y, LIU Y, et al.Efficacy and safety of percutaneous radiofrequency ablation versus surgical resection for small hepatocellular carcinoma:a meta-analysis of 23 studies[J].J Cancer Res Clin Oncol, 2015, 141 (1) :1-9.

[26]DUAN C, LIU M, ZHANG Z, et al.Radiofrequency ablation versus hepatic resection for the treatment of early-stage hepatocellular carcinoma meeting Milan criteria:a systematic review and meta-analysis[J].World J Surg Oncol, 2013, 11 (1) :190.

[27]JIN G, NINQ LJ, LI XW, et al.Analysis of short-term effects of three-dimensional conformal radiotherapy with chemoembolization for hepatic carcinoma[J].Trauma Crit Med, 2015, 3 (3) :169-171. (in Chinese) 金罡, 宁路江, 李兴炜, 等.化学治疗栓塞术联合三维适形放射治疗原发性肝癌60例近期疗效观察[J].创伤与急危重病医学, 2015, 3 (3) :169-171.

[28] HU YX, YANG X, QIAO AY, et al.Therapeutic efficacy of transcather arterial chemoembolization for hepatic carcinoma and its influence on hepatic function:a retrospective study of 92 patients[J].Int JSurg, 2010, 37 (1) :28-31. (in Chinese) 胡扬喜, 杨星, 乔安意, 等.肝动脉栓塞化疗治疗原发性肝癌疗效观察 (附92例报告) [J].国际外科学杂志, 2010, 37 (1) :28-31.

[29]TAKAYASU K, ARII S, IKAI I, et al.Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients[J].Gastroenterology, 2006, 131 (2) :461-469.

[30]KIM JW, KIM JH, SUNG KB, et al.Transarterial chemoembolization vs.radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller[J].Am J Gastroenterol, 2014, 109 (8) :1234-1240.

[31]LIU PH, LEE YH, HSU CY, et al.Survival advantage of radiofrequency ablation over transarterial chemoembolization for patients with hepatocellular carcinoma and good performance status within the Milan criteria[J].Ann Surg Oncol, 2014, 21 (12) :3835-3843.

[32]DAI WC, CHEUNG TT, CHOK KS, et al.Radiofrequency ablation versus transarterial chemoembolization for unresectable solitary hepatocellular carcinomas sized 5-8 cm[J].HPB (Oxford) , 2015, 17 (3) :226-231.

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