摘要
经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)是目前公认的治疗中晚期不可切除肝细胞癌(hepatocellular carcinoma,HCC)的首选方法.由于肝硬化背景、HCC的异质性及TACE抵抗等诸多原因,介入治疗疗效差异较大.近年来,分子靶向药物和免疫制剂等创新型药物在临床开始使用,并取得了不错的疗效.但是对于不可切除HCC,使用单一治疗手段患者获益有限,因此基于TACE为主的介入治疗联合靶向免疫治疗的二联、三联、四联治疗方式已逐步成为HCC治疗研究的热点.然而,由于各种联合治疗方案的搭配模式、应用时机、疗效和安全性等尚不明朗,仍需要大样本、前瞻性、多中心的临床研究进一步探索和验证.本文旨在对不可切除HCC各种介入联合治疗方式的相关临床特征及研究现状作一综述.
Abstract
Transcatheter arterial chemoembolization(TACE)is currently recognized as the first choice for the treatment of advanced unresectable hepatocellular carcinoma(HCC).Due to many reasons such as liver cirrhosis background,heterogeneity of HCC and TACE resistance,the curative effect of interventional therapy varies greatly.In recent years,innovative drugs such as molecular targeted drugs and immune preparations have begun to be used clinically and have achieved good results.However,for unresectable HCC,the benefit of a single treatment is often limited.Therefore,TACE-based interventional therapy combined with targeted immunotherapy,dual,triple,and quadruple therapy have gradually become a hot spot in the treatment of HCC.However,since the matching mode,application timing,efficacy and safety of various combined treatment regimens are still unclear,large-sample,prospective,multi-center clinical studies are still needed for further exploration and verification.This article reviews the relevant clinical characteristics and research status of various combined interventional treatments for unresectable HCC.
基金项目
北京红丁香公益事业发展中心项目(BJ-HDX-202210160)