中晚期肝细胞肝癌非手术疗法新进展

doi:10.3760/cma.j.issn.1673-422X.2014.12.015

摘要/Abstract

摘要： 中晚期肝细胞肝癌的治疗策略是减轻病痛、提高生命质量、延长生存。目前国内外最新进展集中在各种局部治疗手段（血管介入治疗、各种消融治疗、放射治疗）的综合治疗及其与靶向治疗药物的联合治疗。另外系统化疗、生物靶向治疗以及中医药治疗等方面亦取得了一定的进展。

关键词: 癌, 肝细胞, 导管消融术, 放射疗法, 药物疗法, 靶向治疗

Abstract: Treatment strategies of advanced hepatocellular carcinoma reduce pain, improve quality of life and prolong survival. The latest developments at home and abroad focus on a variety of topical treatments (endovascular treatment, a variety of ablation therapy, radiation therapy) combined with each other and also combined with targeted therapy. In addition, systemic chemotherapy, biological targeting therapy and traditional Chinese medicine have achieved some new progressions.

Key words: Carcinoma, hepatocellular, Catheter ablation, Radiotherapy, Drug therapy, Targeted therapy

鲁光平. 中晚期肝细胞肝癌非手术疗法新进展[J]. 国际肿瘤学杂志, 2014, 41(12): 925-929.

LU Guang-Ping. Non-surgical treatment of hepatocellular carcinoma[J]. Journal of International Oncology, 2014, 41(12): 925-929.

参考文献

［1］ Nordenstedt H, White DL, ElSerag HB. The changing pattern of epidemiology in hepatocellular carcinoma［J］. Dig Liver Dis, 2010, 42(suppl 3): S206S214. ［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. ［3］ Mancuso A. Management of hepatocellular carcinoma: enlightening the gray zones［J］. World J Hepatol, 2013, 5(6):302310. ［4］ Pinter M, Hucke F, Graziadei I, et al. Advancedstage hepatocellular carcinoma: transarterial chemoembolization versus sorafenib［J］. Radiology, 2012, 263(2):590599. ［5］ Choi J, Shim JH, Shin YM, et al. Clinical significance of the best response during repeated transarterial chemoembolization in the treatment of hepatocellular carcinoma［J］. J Hepatol, 2014, 60(6): 12121218. ［6］ Sergio A, Cristofori C, Cardin R, et al. Transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): the role of angiogenesis and invasiveness［J］. Am J Gastroenterol, 2008,103(4):914921. ［7］ Kumamoto T, Tanaka K, Matsuo K, et al. Adjuvant hepatic arterial infusion chemotherapy with 5Fluorouracil and interferon after curative resection of hepatocellular carcinoma: a preliminary report［J］. Anticancer Res, 2013, 33(12):55855590. ［8］ Honda Y, Kimura T, Aikata H, et al. Stereotactic body radiation therapy combined with transcatheter arterial chemoembolization for small hepatocellular carcinoma［J］. J Gastroenterol Hepatol, 2013, 28(3): 530536. ［9］ Jiang G, Xu X, Ren S, et al. Combining transarterial chemoembolization with radiofrequency ablation for hepatocellular carcinoma［J］. Tumour Biol, 2014, 35(4):34053408. ［10］ Kane RC, Farrell AT, Madabushi R, et al. Sorafenib for the treatment of unresectable hepatocellular carcinoma［J］. Oncologist, 2009, 14(1):95100. ［11］ Kudo M, Imanaka K, Chida N, et al. Phase Ⅲ study of sorafenib after transarterial chemoembolisation in Japanese and Korean patients with unresectable hepatocellular carcinoma［J］. Eur J Cancer, 2011, 47(14):21172127. ［12］ Shiina S, Tateishi R, Imamura M, et al. Percutaneous ethanol injection for hepatocellular carcinoma: 20year outcome and prognostic factors［J］. Liver Int, 2012, 32(9):14341442. ［13］ Feng K, Ma KS. Value of radiofrequency ablation in the treatment of hepatocellular carcinoma［J］. World J Gastroenterol， 2014, 20(20):59875998. ［14］ Liu J, Qian LX. Therapeutic efficacy comparison of radiofrequency ablation in hepatocellular carcinoma and metastatic liver cancer［J］. Exp Ther Med, 2014, 7(4):897900. ［15］ Huang S, Yu J, Liang P, et al. Percutaneous microwave ablation for hepatocellular carcinoma adjacent to large vessels: a longterm followup［J］. Eur J Radiol, 2014, 83(3):552558. ［16］ Ong SL, Gravante G, Metcalfe MS, et al. Efficacy and safety of microwave ablation for primary and secondary liver malignancies: a systematic review［J］. Eur J Gastroenterol Hepatol, 2009, 21(6):599605. ［17］ Zhang ZM, Guo JX, Zhang ZC, et al. Therapeutic options for intermediateadvanced hepatocellular carcinoma［J］. World J Gastroenterol, 2011, 17(13):16851689. ［18］ Li Z, Zhang C, Lou C, et al. Comparison of percutaneous cryosurgery and surgical resection for the treatment of small hepatocellular carcinoma［J］. Oncol Lett, 2013, 6(1):239245. ［19］ Shen HP, Gong JP, Zuo GQ. Role of highintensity focused ultrasound in treatment of hepatocellular carcinoma［J］. Am Surg, 2011, 77(11):14961501. ［20］ Cheung TT, Fan ST, Chu FS, et al. Survival analysis of highintensity focused ultrasound ablation in patients with small hepatocellular carcinoma［J］. HPB(Oxford), 2013, 15(8):567573. ［21］ Sanuki N, Takeda A, Mizuno T, et al. Tumor response on CT following hypofractionated stereotactic ablative body radiotherapy for small hypervascular hepatocellular carcinoma with cirrhosis［J］. AJR Am J Roentgenol, 2013, 201(6): W812820. ［22］ Qin S, Bai Y, Lim HY, et al. Randomized, multicenter, openlabel study of oxaliplatin plus fluorouracil/leucovorin versus doxorubicin as palliative chemotherapy in patients with advanced hepatocellular carcinoma from Asia［J］. J Clin Oncol, 2013, 31（28）:35013508. ［23］ Yoon EL, Yeon JE, Lee HJ, et al. Systemic cytotoxic chemotherapy of patients with advanced hepatocellular carcinoma in the era of sorafenib nonavailability［J］. Clin Gastroenterol, 2014, 48(3):e2229. ［24］ Shao YY, Lin ZZ, Hsu C, et al. Efficacy, safety, and potential biomarkers of thalidomide plus metronomic chemotherapy for advanced hepatocellular carcinoma［J］. Oncology, 2012, 82(1):5966. ［25］ Huang TS, Shyu YC, Chen HY, et al. A systematic review and metaanalysis of adjuvant interferon therapy after curative treatment for patients with viral hepatitisrelated hepatocellular carcinoma［J］. J Viral Hepat, 2013, 20(10):729743. ［26］ Pan CC, Huang ZL, Li W, et al. Serum alphafetoprotein measurement in predicting clinical outcome related to autologous cytokineinduced killer cells in patients with hepatocellular carcinoma undergone minimally invasive therapy［J］. Chin J Cancer, 2010, 29(6): 596602. ［27］ D′Anzeo M, Faloppi L, Scartozzi M, et al. The role of MicroRNAs in Hepatocellular Carcinoma: From Molecular Biology to Treatment. Molecules［J］. 2014, 19(5):63936406. ［28］ Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma［J］. N Engl J Med, 2008, 359(4):378390. ［29］ Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the AsiaPacific region with advanced hepatocellular carcinoma: a phase III randomised, doubleblind, placebocontrolled trial［J］. Lancet Oncol, 2009, 10(1):2534. ［30］ Hu H, Duan Z, Long X, et al. Sorafenib combined with transarterial chemoembolization versus transarterial chemoembolization alone for advancedstage hepatocellular carcinoma: a propensity score matching study［J］. PLoS One, 2014, 9(5):e96620. ［31］ Chan SL, Yeo W. Development of systemic therapy for hepatocellular carcinoma at 2013: updates and insights［J］. World J Gastroenterol, 2014, 20(12):31353145. ［32］ Cheung F, Wang X, Wang N, et al. Chinese medicines as an adjuvant therapy for unresectable hepatocellular carcinoma during transarterial chemoembolization: a metaanalysis of randomized controlled trials［J］. Evid Based Complement Alternat Med, 2013,2013: 487919. ［33］ Ng L, TungPing Poon R, Yau S, et al. Suppression of actopaxin impairs hepatocellular carcinoma metastasis through modulation of cell migration and invasion［J］. Hepatology, 2013, 58(2):667679.

[1]	钱晓涛, 石子宜, 胡格, 吴晓维. Ⅲ~ⅣA期食管鳞状细胞癌放化疗后行巩固化疗的疗效：一项真实世界临床研究[J]. 国际肿瘤学杂志, 2024, 51(6): 326-331.
[2]	郭泽浩, 张俊旺. PFDN及其亚基在肿瘤发生发展中的作用[J]. 国际肿瘤学杂志, 2024, 51(6): 350-353.
[3]	王盈, 刘楠, 郭兵. 抗体药物偶联物在转移性乳腺癌治疗中的研究进展[J]. 国际肿瘤学杂志, 2024, 51(6): 364-369.
[4]	高凡, 王萍, 杜超, 褚衍六. 肠道菌群与结直肠癌非手术治疗的相关研究进展[J]. 国际肿瘤学杂志, 2024, 51(6): 376-381.
[5]	王丽, 刘志华, 杨伟洪, 蒋凤莲, 李全泳, 宋浩杰, 鞠文东. ROS1突变肺腺鳞癌合并脑梗死为主要表现的Trousseau综合征1例[J]. 国际肿瘤学杂志, 2024, 51(6): 382-384.
[6]	范志鹏, 余静, 胡静, 廖正凯, 徐禹, 欧阳雯, 谢丛华. 炎症标志物的变化趋势对一线接受免疫联合化疗的晚期非小细胞肺癌患者预后的预测价值[J]. 国际肿瘤学杂志, 2024, 51(5): 257-266.
[7]	王俊毅, 洪楷彬, 纪荣佳, 陈大朝. 癌结节对结直肠癌根治性切除术后肝转移的影响[J]. 国际肿瘤学杂志, 2024, 51(5): 280-285.
[8]	顾芳萌, 徐晨阳, 雷大鹏. 人工智能辅助电子喉镜检查在喉癌及喉癌前病变诊治中的研究进展[J]. 国际肿瘤学杂志, 2024, 51(5): 303-307.
[9]	王培鑫, 赵军, 徐世红, 姜朝阳, 王小强, 杨红娟. 铁死亡相关机制在骨肉瘤中的应用进展[J]. 国际肿瘤学杂志, 2024, 51(5): 308-311.
[10]	张文馨, 夏泠, 彭晋, 周福祥. 甲胎蛋白升高型胃肝样腺癌1例并文献复习[J]. 国际肿瘤学杂志, 2024, 51(5): 312-315.
[11]	王昆, 周中新, 臧其威. 血清TGF-β1、VEGF水平对非小细胞肺癌患者单孔胸腔镜根治术后复发的预测价值[J]. 国际肿瘤学杂志, 2024, 51(4): 198-203.
[12]	杨毫, 施贵冬, 张程城, 张跃, 张力文, 付茂勇. 信迪利单抗与替雷利珠单抗在进展期食管鳞状细胞癌新辅助治疗中的疗效及安全性对比[J]. 国际肿瘤学杂志, 2024, 51(4): 210-216.
[13]	姚益新, 沈煜霖. 血清SOCS3、TXNIP水平对肝细胞癌TACE治疗预后的预测价值[J]. 国际肿瘤学杂志, 2024, 51(4): 217-222.
[14]	胡婷婷, 王越华. 电子鼻与线虫鼻——新型早期癌症筛查工具[J]. 国际肿瘤学杂志, 2024, 51(4): 223-226.
[15]	杨智, 陆以乔, 顾花艳, 丁佳玲, 郭贵龙. 肿瘤微环境介导乳腺癌靶向治疗耐药的研究进展[J]. 国际肿瘤学杂志, 2024, 51(4): 235-238.