肝细胞癌非手术治疗的发展现状

于志远; 杨诗语; 李佳启; 孙岩

doi:10.3969/j.issn.1001-5256.2021.05.048

肝细胞癌非手术治疗的发展现状

DOI: 10.3969/j.issn.1001-5256.2021.05.048

哈尔滨医科大学附属第二医院普外七科，哈尔滨 150081

基金项目:

黑龙江省自然基金资助项目 (H2016028)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：于志远、杨诗语负责文章选题，资料分析，撰写论文；于志远、李佳启负责整理文献，设计论文框架及修改论文；孙岩负责帮助拟定写作思路，批改文章并最后定稿。

详细信息

作者简介:
于志远(1995—)，男，主要从事肝胆疾病诊治方面的研究

通信作者:
孙岩，sunyandoctor@163.com

中图分类号: R735.7
计量
- 文章访问数: 570
- HTML全文浏览量: 110
- PDF下载量: 55
- 被引次数: 0
出版历程
- 收稿日期: 2020-10-26
- 录用日期: 2020-11-11
- 出版日期: 2021-05-20

Current developmental status of non-surgical treatment of hepatocellular carcinoma

Seventh Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China

摘要

摘要: 肝细胞癌是临床上常见且死亡率较高的恶性肿瘤之一。随着影像及介入技术的进步，经肝动脉化疗栓塞术、局部消融治疗等应用日益广泛，在某些早期肝细胞癌的治疗中甚至能达到与手术相同的效果。精准医学和生物医学也得到蓬勃发展，放化疗被更准确、有效的应用于肝细胞癌的治疗中，分子靶向治疗、免疫治疗、基因治疗等成为未来的突破方向。就肝细胞癌非手术治疗的最新进展进行综述。
- 癌, 肝细胞 /
- 化学栓塞, 治疗性 /
- 消融技术 /
- 生物疗法
Abstract: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with high mortality in clinical practice. With the development of imaging and interventional techniques, transcatheter arterial chemoembolization and local ablation are more and more widely used for treatment and can even achieve a similar effect as surgery in the treatment of some types of early-stage HCC. In addition, precision medicine and biomedicine have also developed vigorously; radiochemotherapy is more accurate and effective in the treatment of HCC, and molecular targeted therapy, immunotherapy, and gene therapy have become the directions for breakthrough in the future. This article reviews the latest advances in the non-surgical treatment of HCC.
- Carcinoma, Hepatocellular /
- Chemoembolization, Therapeutic /
- Ablation Techniques /
- Biological Therapy

HTML全文

参考文献(38)

[1]	XIE DY, REN ZG, ZHOU J, et al. 2019 Chinese clinical guidelines for the management of hepatocellular carcinoma: Updates and insights[J]. Hepatobiliary Surg Nutr, 2020, 9(4): 452-463. DOI: 10.21037/hbsn-20-480.
[2]	LLOVET JM, BRUIX J. Novel advancements in the management of hepatocellular carcinoma in 2008[J]. J Hepatol, 2008, 48(Suppl 1): s20-s37. DOI: 10.1016/j.jhep.2008.01.022.
[3]	ZHU ZM, ZHAO ZJ, TANG CX. Research advances in apatinib combined with transcatheter arterial embolization in the treatment of hepatocellular carcinoma[J]. J Clin Hepatol, 2020, 36(10): 2325-2328. DOI: 10.3969/j.issn.1001-5256.2020.10.036. 朱泽民, 赵志坚, 唐才喜. 阿帕替尼联合经肝动脉化疗栓塞术治疗肝细胞癌的研究进展[J]. 临床肝胆病杂志, 2020, 36(10): 2325-2328. DOI: 10.3969/j.issn.1001-5256.2020.10.036.
[4]	HUANG D, DAI H, TANG K, et al. A versatile UCST-type composite microsphere for image-guided chemoembolization and photothermal therapy against liver cancer[J]. Nanoscale, 2020, 12(38): 20002-20015. DOI: 10.1039/d0nr04592f.
[5]	ZHAO J, LI YS, LIU ZX, et al. Nanosized drug-eluting bead for transcatheter arterial chemoembolization (ND-TACE)[J]. J Mater Chem B, 2020, 8(37): 8684-8694. DOI: 10.1039/d0tb01295e.
[6]	GUO QY, WEN F. Current situation and prospect of interventional treatment of hepatocellular carcinoma[J]. J Clin Hepatol, 2013, 29(10): 721-725. DOI: 10.3969/j.issn.1001-5256.2013.10.001. 郭启勇, 温锋. 肝细胞癌介入治疗的现状与展望[J]. 临床肝胆病杂志, 2013, 29(10): 721-725. DOI: 10.3969/j.issn.1001-5256.2013.10.001.
[7]	TSAI WL, SUN WC, CHEN WC, et al. Hepatic arterial infusion chemotherapy vs transcatheter arterial embolization for patients with huge unresectable hepatocellular carcinoma[J]. Medicine (Baltimore), 2020, 99(32): e21489. DOI: 10.1097/MD.0000000000021489.
[8]	YOUNG S, CRAIG P, GOLZARIAN J. Current trends in the treatment of hepatocellular carcinoma with transarterial embolization: A cross-sectional survey of techniques[J]. Eur Radiol, 2019, 29(6): 3287-3295. DOI: 10.1007/s00330-018-5782-7.
[9]	YOON SM, RYOO BY, LEE SJ, et al. Efficacy and safety of transarterial chemoembolization plus external beam radiotherapy vs sorafenib in hepatocellular carcinoma with macroscopic vascular invasion: A randomized clinical Trial[J]. JAMA Oncol, 2018, 4(5): 661-669. DOI: 10.1001/jamaoncol.2017.5847.
[10]	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. DOI: 10.1016/S2468-1253(18)30029-3.
[11]	Bureau of Medical AdministrationNational Health Commission of the People's Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China (2019 edition)[J]. J Clin Hepatol, 2020, 36(2): 277-292. DOI: 10.3969/j.issn.1001-5256.2020.02.007. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范(2019年版)[J]. 临床肝胆病杂志, 2020, 36(2): 277-292. DOI: 10.3969/j.issn.1001-5256.2020.02.007.
[12]	YAMAO T, IMAI K, YAMASHITA YI, et al. Surgical treatment strategy for hepatocellular carcinoma in patients with impaired liver function: Hepatic resection or radiofrequency ablation?[J]. HPB (Oxford), 2018, 20(3): 244-250. DOI: 10.1016/j.hpb.2017.08.031.
[13]	SCHER N, JANORAY G, RIET FG, et al. Stereotactic body radiation therapy for hepatocellular carcinoma: Results from a retrospective multicentre study[J]. Cancer Radiother, 2019, 23(2): 104-115. DOI: 10.1016/j.canrad.2018.07.138.
[14]	SEKINO Y, OKUMURA T, FUKUMITSU N, et al. Proton beam therapy for hepatocellular carcinoma associated with inferior vena cava tumor thrombus[J]. J Cancer Res Clin Oncol, 2020, 146(3): 711-720. DOI: 10.1007/s00432-019-03096-7.
[15]	SHIBUYA K, OHNO T, TERASHIMA K, et al. Short-course carbon-ion radiotherapy for hepatocellular carcinoma: A multi-institutional retrospective study[J]. Liver Int, 2018, 38(12): 2239-2247. DOI: 10.1111/liv.13969.
[16]	LEE EW, ALANIS L, CHO SK, et al. Yttrium-90 selective internal radiation therapy with glass microspheres for hepatocellular carcinoma: Current and updated literature review[J]. Korean J Radiol, 2016, 17(4): 472-488. DOI: 10.3348/kjr.2016.17.4.472.
[17]	TAYLOR AC, MADDIRELA D, WHITE SB. Role of radioembolization for biliary tract and primary liver cancer[J]. Surg Oncol Clin N Am, 2019, 28(4): 731-743. DOI: 10.1016/j.soc.2019.07.001.
[18]	王艳红. 肝癌的综合治疗之我见[J/CD]. 中华临床医师杂志(电子版), 2015, 9(19): 3488-3493. DOI:10.3877/cma.j.issn.1674-0785.2015.19.002. WANG YH. Comprehensive treatment of liver cancer[J/CD]. Chin J Clinicians(Electronic Edition), 2015, 9(19): 3488-3493. DOI:10.3877/cma.j.issn.1674-0785.2015.19.002.
[19]	HUANG S, LI C, WANG W, et al. A54 peptide-mediated functionalized gold nanocages for targeted delivery of DOX as a combinational photothermal-chemotherapy for liver cancer[J]. Int J Nanomedicine, 2017, 12: 5163-5176. DOI: 10.2147/IJN.S131089.
[20]	BRUIX J, TAKAYAMA T, MAZZAFERRO V, et al. Adjuvant sorafenib for hepatocellular carcinoma after resection or ablation (STORM): A phase 3, randomised, double-blind, placebo-controlled trial[J]. Lancet Oncol, 2015, 16(13): 1344-1354. DOI: 10.1016/S1470-2045(15)00198-9.
[21]	LI M, SU Y, ZHANG F, et al. A dual-targeting reconstituted high density lipoprotein leveraging the synergy of sorafenib and antimiRNA21 for enhanced hepatocellular carcinoma therapy[J]. Acta Biomater, 2018, 75: 413-426. DOI: 10.1016/j.actbio.2018.05.049.
[22]	KUDO M, FINN RS, QIN S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: A randomised phase 3 non-inferiority trial[J]. Lancet, 2018, 391(10126): 1163-1173. DOI: 10.1016/S0140-6736(18)30207-1
[23]	KIMURA T, KATO Y, OZAWA Y, et al. Immunomodulatory activity of lenvatinib contributes to antitumor activity in the Hepa1-6 hepatocellular carcinoma model[J]. Cancer Sci, 2018, 109(12): 3993-4002. DOI: 10.1111/cas.13806.
[24]	BRUIX J, QIN S, MERLE P, et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): A randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet, 2017, 389(10064): 56-66. DOI: 10.1016/S0140-6736(16)32453-9.
[25]	DEEKS ED. Cabozantinib: A review in advanced hepatocellular carcinoma[J]. Target Oncol, 2019, 14(1): 107-113. DOI: 10.1007/s11523-019-00622-y.
[26]	KASPRZAK A, ADAMEK A. Role of Endoglin (CD105) in the progression of hepatocellular carcinoma and anti-angiogenic therapy[J]. Int J Mol Sci, 2018, 19(12): 3887. DOI: 10.3390/ijms19123887.
[27]	LEE JH, LEE JH, LIM YS, et al. Adjuvant immunotherapy with autologous cytokine-induced killer cells for hepatocellular carcinoma[J]. Gastroenterology, 2015, 148(7): 1383-1391. e6. DOI: 10.1053/j.gastro.2015.02.055.
[28]	LIU LX, CAI W. Current situation and prospect of immunotherapy for hepatocellular carcinoma[J]. Chin J Dig Surg, 2020, 19(2): 119-122. DOI: 10.3760/ma.j.issn.1673-9752.2020.02.002. 刘连新, 蔡伟. 肝细胞癌免疫治疗的现状和展望[J]. 中华消化外科杂志, 2020, 19(2): 119-122. DOI: 10. 3760/cma. j. issn. 1673-9752. 2020.02.002.
[29]	PINTER M, PECK-RADOSAVLJEVIC M. Review article: Systemic treatment of hepatocellular carcinoma[J]. Aliment Pharmacol Ther, 2018, 48(6): 598-609. DOI: 10.1111/apt.14913.
[30]	SANMAMED MF, CHEN L. A paradigm shift in cancer immunotherapy: From enhancement to normalization[J]. Cell, 2019, 176(3): 677. DOI: 10.1016/j.cell.2019.01.008.
[31]	WAIDMANN O. Recent developments with immunotherapy for hepatocellular carcinoma[J]. Expert Opin Biol Ther, 2018, 18(8): 905-910. DOI: 10.1080/14712598.2018.1499722.
[32]	ZHANG BH, PAN XP, COBB GP, et al. MicroRNAs as oncogenes and tumor suppressors[J]. Dev Biol, 2009, 302(1): 1-12. DOI: 10.1016/j.ydbio.2006.08.028.
[33]	TANG ZH, TANG CW, WANG SH, et al. The research situation and progress in the invasion and metastasis mechanism of intrahepatic cholangiocarcinoma[J]. Chin J Dig Surg, 2019, 18(4): 321-327. DOI: 10.3760 / cma.j.issn.1673-9752.2019.04.006. 汤朝晖, 唐陈伟, 王寿华, 等. 肝内胆管癌侵袭转移机制的研究现状与进展[J]. 中华消化外科杂志, 2019, 18(4): 321-327. DOI: 10.3760/cma.j.issn.1673-9752.2019.04.006.
[34]	WEILER J, HUNZIKER J, HALL J. Anti-miRNA oligonucleotides (AMOs): Ammunition to target miRNAs implicated in human disease?[J]. Gene Ther, 2006, 13(6): 496-502. DOI: 10.1038/sj.gt.3302654.
[35]	HU Q, WANG K, SUN X, et al. A redox-sensitive, oligopeptide-guided, self-assembling, and efficiency-enhanced (ROSE) system for functional delivery of microRNA therapeutics for treatment of hepatocellular carcinoma[J]. Biomaterials, 2016, 104: 192-200. DOI: 10.1016/j.biomaterials.2016.07.016.
[36]	LI F, WANG F, ZHU C, et al. miR-221 suppression through nanoparticle-based miRNA delivery system for hepatocellular carcinoma therapy and its diagnosis as a potential biomarker[J]. Int J Nanomedicine, 2018, 13: 2295-2307. DOI: 10.2147/IJN.S157805.
[37]	LIU X, LI M, WANG X, et al. Effects of adjuvant traditional Chinese medicine therapy on long-term survival in patients with hepatocellular carcinoma[J]. Phytomedicine, 2019, 62: 152930. DOI: 10.1016/j.phymed.2019.152930.
[38]	LI C, XU X. Biological functions and clinical applications of exosomal non-coding RNAs in hepatocellular carcinoma[J]. Cell Mol Life Sci, 2019, 76(21): 4203-4219. DOI: 10.1007/s00018-019-03215-0.