肝细胞癌血管介入治疗临床研究新认知

文良志; 肖潇; 颜綦先; 王军

doi:10.3969/j.issn.1001-5256.2021.08.005

肝细胞癌血管介入治疗临床研究新认知

DOI: 10.3969/j.issn.1001-5256.2021.08.005

陆军军医大学大坪医院消化内科，重庆 400042

基金项目:

陆军军医大学科技创新能力提升专项项目 (2019XLC3045);

国家自然科学基金 (81802459);

重庆市自然科学基金 (cstc2018jcyjAX0603)

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：文良志负责论文撰写；肖潇、颜綦先负责TACE及HAIC方面内容审核；王军负责内容总体指导和论文修改。

详细信息

通信作者:
王军，wjun_7311@126.com

中图分类号: R735.7
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- 被引次数: 0
出版历程
- 收稿日期: 2021-05-28
- 录用日期: 2021-05-28
- 出版日期: 2021-08-20

Advances in clinical research on vascular interventional therapy for hepatocellular carcinoma

Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing 400042, China

Research funding:

Science and Technology Innovation Ability Enhancement Special Project of Army Military Medical University (2019XLC3045);

National Natural Science Foundation of China (81802459);

Natural Science Foundation of Chongqing (cstc2018jcyjAX0603)

摘要

摘要: 肝细胞癌(HCC)血管介入治疗是不能手术切除HCC的最主要治疗方式，主要包括经肝动脉化疗栓塞术以及肝动脉灌注化疗等。随着新型材料和新术式的研发及应用，上述治疗方案也得到改良和优化，诸多临床研究探讨了各种不同方案对HCC的治疗效果并取得系列新进展，为临床HCC血管介入治疗提供新策略和理论基础。现探讨HCC血管介入治疗临床研究领域相关新认知。
- 癌，肝细胞 /
- 化学栓塞, 治疗性 /
- 化学疗法, 肿瘤, 局部灌注
Abstract: Vascular interventional therapy for hepatocellular carcinoma (HCC) is the most important treatment modality for unresectable HCC, including transcatheter arterial chemoembolization and hepatic arterial infusion chemotherapy. With the development and application of new materials and surgical procedures, the above treatment regimens have been modified and optimized, and various clinical studies have discussed the clinical effect of different regimens in the treatment of HCC and have made new achievements, which provides new strategies and a theoretical basis for vascular interventional therapy for HCC in clinical practice. This article summarizes the new advances in the clinical research on vascular interventional therapy for HCC.
- Carcinoma, Hepatocellular /
- Chemoembolization, Therapeutic /
- Chemotherapy, Cancer, Regional Perfusion

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参考文献(33)

[1]	SUNG H, FERLAY J, SIEGEL RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.
[2]	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. DOI: 10.1016/j.jhep.2011.12.001.
[3]	MALUCCIO M, COVEY A. Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma[J]. CA Cancer J Clin, 2012, 62(6): 394-399. DOI: 10.3322/caac.21161.
[4]	BREEDIS C, YOUNG G. The blood supply of neoplasms in the liver[J]. Am J Pathol, 1954, 30(5): 969-977.
[5]	LLOVET JM, REAL MI, MONTAÑA X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: A randomised controlled trial[J]. Lancet, 2002, 359(9319): 1734-1739. DOI: 10.1016/S0140-6736(02)08649-X.
[6]	LO CM, NGAN H, TSO WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma[J]. Hepatology, 2002, 35(5): 1164-1171. DOI: 10.1053/jhep.2002.33156.
[7]	GOLFIERI R, GIAMPALMA E, RENZULLI M, et al. Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma[J]. Br J Cancer, 2014, 111(2): 255-264. DOI: 10.1038/bjc.2014.199.
[8]	FACCIORUSSO A, DI MASO M, MUSCATIELLO N. Drug-eluting beads versus conventional chemoembolization for the treatment of unresectable hepatocellular carcinoma: A meta-analysis[J]. Dig Liver Dis, 2016, 48(6): 571-577. DOI: 10.1016/j.dld.2016.02.005.
[9]	CHANG Y, JEONG SW, YOUNG JANG J, et al. Recent updates of transarterial chemoembolilzation in hepatocellular carcinoma[J]. Int J Mol Sci, 2020, 21(21): 8165. DOI: 10.3390/ijms21218165.
[10]	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.
[11]	BARGELLINI I, SACCO R, BOZZI E, et al. Transarterial chemoembolization in very early and early-stage hepatocellular carcinoma patients excluded from curative treatment: A prospective cohort study[J]. Eur J Radiol, 2012, 81(6): 1173-1178. DOI: 10.1016/j.ejrad.2011.03.046.
[12]	European Association for the Study of the Liver. EASL clinical practice guidelines: Management of hepatocellular carcinoma[J]. J Hepatol, 2018, 69(1): 182-236. DOI: 10.1016/j.jhep.2018.03.019.
[13]	RAOUL JL, FORNER A, BOLONDI L, et al. Updated use of TACE for hepatocellular carcinoma treatment: How and when to use it based on clinical evidence[J]. Cancer Treat Rev, 2019, 72: 28-36. DOI: 10.1016/j.ctrv.2018.11.002.
[14]	LIANG L, LI C, DIAO YK, et al. Survival benefits from adjuvant transcatheter arterial chemoembolization in patients undergoing liver resection for hepatocellular carcinoma: A systematic review and meta-analysis[J]. Therap Adv Gastroenterol, 2020, 13: 1756284820977693. DOI: 10.1177/1756284820977693.
[15]	WANG Z, REN Z, CHEN Y, et al. Adjuvant transarterial chemoembolization for HBV-related hepatocellular carcinoma after resection: A randomized controlled study[J]. Clin Cancer Res, 2018, 24(9): 2074-2081. DOI: 10.1158/1078-0432.CCR-17-2899.
[16]	LOPEZ-LOPEZ V, ROBLES-CAMPOS R, BRUSADIN R, et al. ALPPS for hepatocarcinoma under cirrhosis: A feasible alternative to portal vein embolization[J]. Ann Transl Med, 2019, 7(22): 691. DOI: 10.21037/atm.2019.10.57.
[17]	TRUTY MJ, VAUTHEY JN. Uses and limitations of portal vein embolization for improving perioperative outcomes in hepatocellular carcinoma[J]. Semin Oncol, 2010, 37(2): 102-109. DOI: 10.1053/j.seminoncol.2010.03.013.
[18]	ZHANG CW, DOU CW, ZHANG XL, et al. Simultaneous transcatheter arterial chemoembolization and portal vein embolization for patients with large hepatocellular carcinoma before major hepatectomy[J]. World J Gastroenterol, 2020, 26(30): 4489-4500. DOI: 10.3748/wjg.v26.i30.4489.
[19]	KUDO M, ARIZUMI T, UESHIMA K. Assessment for retreatment (ART) score for repeated transarterial chemoembolization in patients with hepatocellular carcinoma[J]. Hepatology, 2014, 59(6): 2424-2425. DOI: 10.1002/hep.26760.
[20]	KLOECKNER R, PITTON MB, DUEBER C, et al. Validation of clinical scoring systems ART and ABCR after transarterial chemoembolization of hepatocellular carcinoma[J]. J Vasc Interv Radiol, 2017, 28(1): 94-102. DOI: 10.1016/j.jvir.2016.06.012.
[21]	SALEM R, LEWANDOWSKI R, ROBERTS C, et al. Use of Yttrium-90 glass microspheres (TheraSphere) for the treatment of unresectable hepatocellular carcinoma in patients with portal vein thrombosis[J]. J Vasc Interv Radiol, 2004, 15(4): 335-345. DOI: 10.1097/01.rvi.0000123319.20705.92.
[22]	MIKELL JK, DEWARAJA YK, OWEN D. Transarterial radioembolization for hepatocellular carcinoma and hepatic metastases: Clinical aspects and dosimetry models[J]. Semin Radiat Oncol, 2020, 30(1): 68-76. DOI: 10.1016/j.semradonc.2019.08.005.
[23]	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. DOI: 10.1016/S1470-2045(17)30683-6.
[24]	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. e2. DOI: 10.1053/j.gastro.2016.08.029.
[25]	SALEM R, GABR A, RIAZ A, et al. Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1, 000-patient 15-year experience[J]. Hepatology, 2018, 68(4): 1429-1440. DOI: 10.1002/hep.29691.
[26]	ANDO E, TANAKA M, YAMASHITA F, et al. Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: Analysis of 48 cases[J]. Cancer, 2002, 95(3): 588-595. DOI: 10.1002/cncr.10694.
[27]	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 Cancer Study Group of Japan[J]. Liver Cancer, 2014, 3(3-4): 458-468. DOI: 10.1159/000343875.
[28]	LYU N, LIN Y, KONG Y, et al. FOXAI: A phase Ⅱ trial evaluating the efficacy and safety of hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin for advanced hepatocellular carcinoma[J]. Gut, 2018, 67(2): 395-396. DOI: 10.1136/gutjnl-2017-314138.
[29]	LYU N, KONG Y, MU L, et al. Hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin vs. sorafenib for advanced hepatocellular carcinoma[J]. J Hepatol, 2018, 69(1): 60-69. DOI: 10.1016/j.jhep.2018.02.008.
[30]	HE MK, LE Y, LI QJ, et al. Hepatic artery infusion chemotherapy using mFOLFOX versus transarterial chemoembolization for massive unresectable hepatocellular carcinoma: A prospective non-randomized study[J]. Chin J Cancer, 2017, 36(1): 83. DOI: 10.1186/s40880-017-0251-2.
[31]	HE M, LI Q, ZOU R, et al. Sorafenib plus hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin vs sorafenib alone for hepatocellular carcinoma with portal vein invasion: A randomized clinical trial[J]. JAMA Oncol, 2019, 5(7): 953-960. DOI: 10.1001/jamaoncol.2019.0250.
[32]	MEI J, TANG YH, WEI W, et al. Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors plus lenvatinib versus PD-1 inhibitors plus lenvatinib for advanced hepatocellular carcinoma[J]. Front Oncol, 2021, 11: 618206. DOI: 10.3389/fonc.2021.618206.
[33]	SAEKI I, YAMASAKI T, MAEDA M, et al. Evaluation of the "assessment for continuous treatment with hepatic arterial infusion chemotherapy" scoring system in patients with advanced hepatocellular carcinoma[J]. Hepatol Res, 2018, 48(3): e87-e97. DOI: 10.1111/hepr.12932.