摘要
Hepatocellular carcinoma(HCC) is the sixth-most common type of cancer worldwide. The only definitive treatment modalities capable of achieving a cure are hepatic resection and hepatic transplantation. However, most patients are not candidates for these therapies. Overall, treatment options are driven by the stage of HCC. Early-stage disease is treated with ablative therapies, with radiofrequency ablation the ablative therapy of choice. Microwave ablation and irreversible electroporation are the other upcoming alternatives. Intermediate-stage disease is managed with transarterial chemoembolization(TACE), while advanced-stage disease is managed by sorafenib, with TACE and radioembolization as other alternatives.
Hepatocellular carcinoma(HCC) is the sixth-most common type of cancer worldwide. The only definitive treatment modalities capable of achieving a cure are hepatic resection and hepatic transplantation. However, most patients are not candidates for these therapies. Overall, treatment options are driven by the stage of HCC. Early-stage disease is treated with ablative therapies, with radiofrequency ablation the ablative therapy of choice. Microwave ablation and irreversible electroporation are the other upcoming alternatives. Intermediate-stage disease is managed with transarterial chemoembolization(TACE), while advanced-stage disease is managed by sorafenib, with TACE and radioembolization as other alternatives.
引文
1 Parkin DM,Bray F,Ferlay J,Pisani P.Global cancer statistics,2002.CA Cancer J Clin 2005;55:74-108[PMID:15761078]
2 Llovet JM,BrúC,Bruix J.Prognosis of hepatocellular carcinoma:the BCLC staging classification.Semin Liver Dis 1999;19:329-338[PMID:10518312]
3 Pugh RN,Murray-Lyon IM,Dawson JL,Pietroni MC,Williams R.Transection of the oesophagus for bleeding oesophageal varices.Br J Surg 1973;60:646-649[PMID:4541913]
4 Toso C,Mentha G,Kneteman NM,Majno P.The place of downstaging for hepatocellular carcinoma.J Hepatol 2010;52:930-936[PMID:20385428 DOI:10.1016/j.jhep.2009.12.032]
5 Forner A,Llovet JM,Bruix J.Hepatocellular carcinoma.Lancet2012;379:1245-1255[PMID:22353262 DOI:10.1016/S0140-6736(11)61347-0]
6 Ahmed M,Brace CL,Lee FT,Goldberg SN.Principles of and advances in percutaneous ablation.Radiology 2011;258:351-369[PMID:21273519 DOI:10.1148/radiol.10081634]
7 Karanicolas PJ,Jarnagin WR,Gonen M,Tuorto S,Allen PJ,De Matteo RP,D’Angelica MI,Fong Y.Long-term outcomes following tumor ablation for treatment of bilateral colorectal liver metastases.JAMA Surg 2013;148:597-601[PMID:23699996DOI:10.1001/jamasurg.2013.1431]
8 Llovet JM,Fuster J,Bruix J.Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma:resection versus transplantation.Hepatology 1999;30:1434-1440[PMID:10573522]
9 Chen J,Huang K,Wu J,Zhu H,Shi Y,Wang Y,Zhao G.Survival after anatomic resection versus nonanatomic resection for hepatocellular carcinoma:a meta-analysis.Dig Dis Sci 2011;56:1626-1633[PMID:21082347 DOI:10.1007/s10620-010-1482-0]
10 Livraghi T,Meloni F,Di Stasi M,Rolle E,Solbiati L,Tinelli C,Rossi S.Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis:Is resection still the treatment of choice?Hepatology2008;47:82-89[PMID:18008357]
11 Cho YK,Kim JK,Kim WT,Chung JW.Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma:a Markov model analysis.Hepatology 2010;51:1284-1290[PMID:20099299 DOI:10.1002/hep.23466]
12 Takayama T,Makuuchi M,Hasegawa K.Single HCC smaller than 2 cm:surgery or ablation?:surgeon’s perspective.J Hepatobiliary Pancreat Sci 2010;17:422-424[PMID:19936598 DOI:10.1007/s00534-009-0239-7]
13 Xu Q,Kobayashi S,Ye X,Meng X.Comparison of hepatic resection and radiofrequency ablation for small hepatocellular carcinoma:a meta-analysis of 16,103 patients.Sci Rep 2014;4:7252[PMID:25429732 DOI:10.1038/srep07252]
14 Lencioni RA,Allgaier HP,Cioni D,Olschewski M,Deibert P,Crocetti L,Frings H,Laubenberger J,Zuber I,Blum HE,Bartolozzi C.Small hepatocellular carcinoma in cirrhosis:randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection.Radiology 2003;228:235-240[PMID:12759473]
15 Giorgio A,Di Sarno A,De Stefano G,Scognamiglio U,Farella N,Mariniello A,Esposito V,Coppola C,Giorgio V.Percutaneous radiofrequency ablation of hepatocellular carcinoma compared to percutaneous ethanol injection in treatment of cirrhotic patients:an Italian randomized controlled trial.Anticancer Res 2011;31:2291-2295[PMID:21737654]
16 Bruix J,Sherman M.Management of hepatocellular carcinoma.Hepatology 2005;42:1208-1236[PMID:16250051]
17 Schoppmeyer K,Weis S,M?ssner J,Fleig WE.Percutaneous ethanol injection or percutaneous acetic acid injection for early hepatocellular carcinoma.Cochrane Database Syst Rev 2009;3:CD006745[PMID:19588401 DOI:10.1002/14651858.CD006745.pub2]
18 Lin SM,Lin CJ,Lin CC,Hsu CW,Chen YC.Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma 19 Shiina S,Teratani T,Obi S,Sato S,Tateishi R,Fujishima T,Ishikawa T,Koike Y,Yoshida H,Kawabe T,Omata M.A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma.Gastroenterology 2005;129:122-130[PMID:16012942]
20 Lin SM,Lin CJ,Lin CC,Hsu CW,Chen YC.Randomised controlled trial comparing percutaneous radiofrequency thermal ablation,percutaneous ethanol injection,and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less.Gut2005;54:1151-1156[PMID:16009687]
21 Brunello F,Veltri A,Carucci P,Pagano E,Ciccone G,Moretto P,Sacchetto P,Gandini G,Rizzetto M.Radiofrequency ablation versus ethanol injection for early hepatocellular carcinoma:A randomized controlled trial.Scand J Gastroenterol 2008;43:727-735[PMID:18569991 DOI:10.1080/00365520701885481]
22 Orlando A,Leandro G,Olivo M,Andriulli A,Cottone M.Radiofrequency thermal ablation vs.percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis:meta-analysis of randomized controlled trials.Am J Gastroenterol 2009;104:514-524[PMID:19174803 DOI:10.1038/ajg.2008.80]
23 Cho YK,Kim JK,Kim MY,Rhim H,Han JK.Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies.Hepatology 2009;49:453-459[PMID:19065676 DOI:10.1002/hep.22648]
24 Germani G,Pleguezuelo M,Gurusamy K,Meyer T,IsgròG,Burroughs AK.Clinical outcomes of radiofrequency ablation,percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma:a meta-analysis.J Hepatol 2010;52:380-388[PMID:20149473 DOI:10.1016/j.jhep.2009.12.004]
25 Weis S,Franke A,M?ssner J,Jakobsen JC,Schoppmeyer K.Radiofrequency(thermal)ablation versus no intervention or other interventions for hepatocellular carcinoma.Cochrane Database Syst Rev 2013;12:CD003046[PMID:24357457 DOI:10 .1002/14651858.CD003046]
26 Lencioni R,Cioni D,Crocetti L,Franchini C,Pina CD,Lera J,Bartolozzi C.Early-stage hepatocellular carcinoma in patients with cirrhosis:long-term results of percutaneous image-guided radiofrequency ablation.Radiology 2005;234:961-967[PMID:15665226]
27 Tateishi R,Shiina S,Teratani T,Obi S,Sato S,Koike Y,Fujishima T,Yoshida H,Kawabe T,Omata M.Percutaneous radiofrequency ablation for hepatocellular carcinoma.An analysis of 1000 cases.Cancer 2005;103:1201-1209[PMID:15690326]
28 Choi D,Lim HK,Rhim H,Kim YS,Lee WJ,Paik SW,Koh KC,Lee JH,Choi MS,Yoo BC.Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment:long-term results and prognostic factors in a large single-institution series.Eur Radiol 2007;17:684-692[PMID:17093964]
29 N’Kontchou G,Mahamoudi A,Aout M,Ganne-CarriéN,Grando V,Coderc E,Vicaut E,Trinchet JC,Sellier N,Beaugrand M,Seror O.Radiofrequency ablation of hepatocellular carcinoma:long-term results and prognostic factors in 235 Western patients with cirrhosis.Hepatology 2009;50:1475-1483[PMID:19731239 DOI:10.1002/hep.23181]
30 Kalra N,Kang M,Bhatia A,Duseja AK,Dhiman RK,Arya VK,Rajwanshi A,Chawla YK,Khandelwal N.Role of radiofrequency ablation in unresectable hepatocellular carcinoma:An Indian experience.Indian J Radiol Imaging 2013;23:139-144[PMID:24082478 DOI:10.4103/0971-3026.116569]
31 Vivarelli M,Guglielmi A,Ruzzenente A,Cucchetti A,Bellusci R,Cordiano C,Cavallari A.Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver.Ann Surg 2004;240:102-107[PMID:15213625]
32 Ogihara M,Wong LL,Machi J.Radiofrequency ablation versus surgical resection for single nodule hepatocellular carcinoma:longterm outcomes.HPB(Oxford)2005;7:214-221[PMID:18333193DOI:10.1080/13651820510028846]
33 Wakai T,Shirai Y,Suda T,Yokoyama N,Sakata J,Cruz PV,Kawai H,Matsuda Y,Watanabe M,Aoyagi Y,Hatakeyama K.Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma 34 Guglielmi A,Ruzzenente A,Valdegamberi A,Pachera S,Campagnaro T,D’Onofrio M,Martone E,Nicoli P,Iacono C.Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma in cirrhosis.J Gastrointest Surg 2008;12:192-198[PMID:17999123]
35 Abu-Hilal M,Primrose JN,Casaril A,Mc Phail MJ,Pearce NW,Nicoli N.Surgical resection versus radiofrequency ablation in the treatment of small unifocal hepatocellular carcinoma.J Gastrointest Surg 2008;12:1521-1526[PMID:18592325 DOI:10.1007/s11605-008-0553-4]
36 Hiraoka A,Horiike N,Yamashita Y,Koizumi Y,Doi K,Yamamoto Y,Hasebe A,Ichikawa S,Yano M,Miyamoto Y,Ninomiya T,Otomi Y,Kokame M,Iwamura T,Ishimaru Y,Sogabe I,Kashihara K,Nishiura S,Ootani H,Takamura K,Kawasaki H.Efficacy of radiofrequency ablation therapy compared to surgical resection in 164 patients in Japan with single hepatocellular carcinoma smaller than 3 cm,along with report of complications.Hepatogastroenterology 2008;55:2171-2174[PMID:19260499]
37 Peng ZW,Chen MS,Liang HH,Gao HJ,Zhang YJ,Li JQ,Zhang YQ,Lau WY.A case-control study comparing percutaneous radiofrequency ablation alone or combined with transcatheter arterial chemoembolization for hepatocellular carcinoma.Eur J Surg Oncol 2010;36:257-263[PMID:19643561 DOI:10.1016/j.ejso.2009.07.007]
38 Chen MS,Li JQ,Zheng Y,Guo RP,Liang HH,Zhang YQ,Lin XJ,Lau WY.A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma.Ann Surg 2006;243:321-328[PMID:16495695]
39 Huang J,Yan L,Cheng Z,Wu H,Du L,Wang J,Xu Y,Zeng Y.A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria.Ann Surg 2010;252:903-912[PMID:21107100 DOI:10.1097/SLA.0b013e3181ef c656]
40 Lu DS,Yu NC,Raman SS,Limanond P,Lassman C,Murray K,Tong MJ,Amado RG,Busuttil RW.Radiofrequency ablation of hepatocellular carcinoma:treatment success as defined by histologic examination of the explanted liver.Radiology 2005;234:954-960[PMID:15681691]
41 Rossi S,Garbagnati F,Lencioni R,Allgaier HP,MarchianòA,Fornari F,Quaretti P,Tolla GD,Ambrosi C,Mazzaferro V,Blum HE,Bartolozzi C.Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply.Radiology 2000;217:119-126[PMID:11012432]
42 Yamasaki T,Kurokawa F,Shirahashi H,Kusano N,Hironaka K,Okita K.Percutaneous radiofrequency ablation therapy for patients with hepatocellular carcinoma during occlusion of hepatic blood flow.Comparison with standard percutaneous radiofrequency ablation therapy.Cancer 2002;95:2353-2360[PMID:12436442]
43 Veltri A,Moretto P,Doriguzzi A,Pagano E,Carrara G,Gandini G.Radiofrequency thermal ablation(RFA)after transarterial chemoembolization(TACE)as a combined therapy for unresectable non-early hepatocellular carcinoma(HCC).Eur Radiol 2006;16:661-669[PMID:16228211]
44 Helmberger T,Dogan S,Straub G,Schrader A,Jüngst C,Reiser M,Waggershauser T,Jakobs T,Hoffmann RT,L?he F,Graeb C,Rau HG,Schauer R,Jauch KW,Caselmann WH,G?ke B,Jüngst D.Liver resection or combined chemoembolization and radiofrequency ablation improve survival in patients with hepatocellular carcinoma.Digestion 2007;75:104-112[PMID:17598962]
45 Lencioni R,Crocetti L,Petruzzi P,Vignali C,Bozzi E,Della Pina C,Bargellini I,Cioni D,Oliveri F,De Simone P,Bartolozzi C,Brunetto M,Filipponi F.Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma:a pilot clinical study.J Hepatol 2008;49:217-222[PMID:18486261 DOI:10 .1016/j.jhep.2008.03.021]
46 Kudo M.Local ablation therapy for hepatocellular carcinoma:current status and future perspectives.J Gastroenterol 2004;39:205-214[PMID:15064996]
47 Wang YB,Chen MH,Yan K,Yang W,Dai Y,Yin SS.Quality of life after radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma:comparison with transcatheter arterial chemoembolization alone.Qual Life Res 2007;16:389-397[PMID:17111232]
48 Morimoto M,Numata K,Kondou M,Nozaki A,Morita S,Tanaka K.Midterm outcomes in patients with intermediatesized hepatocellular carcinoma:a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization.Cancer 2010;116:5452-5460[PMID:20672352 DOI:10.1002/cncr.25314]
49 Celsion.Phase 3 study of Thermo Dox with radiofrequency ablation(RFA)in treatment of hepatocellular carcinoma(HCC).In:Clinical Trials.gov[Internet].Bethesda(MD):National Library of Medicine(US).Available from:URL:http://www.clinicaltrial.gov/ct2/show/NCT00617981 NLM Identifier:NCT00617981
50 Nicolini A,Martinetti L,Crespi S,Maggioni M,Sangiovanni A.Transarterial chemoembolization with epirubicin-eluting beads versus transarterial embolization before liver transplantation for hepatocellular carcinoma.J Vasc Interv Radiol 2010;21:327-332[PMID:20097098 DOI:10.1016/j.jvir.2009.10.038]
51 Majno PE,Mentha G,Mazzaferro V.Partial hepatectomy versus radiofrequency ablation for hepatocellular carcinoma:confirming the trial that will never be,and some comments on the indications for liver resection.Hepatology 2010;51:1116-1118[PMID:20373366 DOI:10.1002/hep.23648]
52 Mack MG,Straub R,Eichler K,Engelmann K,Zangos S,Roggan A,Woitaschek D,B?ttger M,Vogl TJ.Percutaneous MR imagingguided laser-induced thermotherapy of hepatic metastases.Abdom Imaging 2001;26:369-374[PMID:11441548]
53 Eickmeyer F,Schwarzmaier HJ,Müller FP,Nakic Z,Yang Q,Fiedler V.[Survival after laser-induced interstitial thermotherapy of colorectal liver metastases--a comparison of first clinical experiences with current therapy results].Rofo 2008;180:35-41[PMID:18008194]
54 Zhou ZJ,Xu RD,Li WK,Zhuang WX,Lu LG,Shao PJ,Chen XM,Luo PF.[Transarterial oily chemoembolization combined with interstitial laser thermotherapy for treatment of hepatocellular carcinoma].Nan Fang Yi Ke Da Xue Xue Bao 2007;27:1866-1868[PMID:18159005]
55 Xu G,Luo G,He L,Li J,Shan H,Zhang R,Li Y,Gao X,Lin S,Wang G.Follow-up of high-intensity focused ultrasound treatment for patients with hepatocellular carcinoma.Ultrasound Med Biol2011;37:1993-1999[PMID:22036638 DOI:10.1016/j.ultrasmedb io.2011.08.011]
56 Pacella CM,Francica G,Di Lascio FM,Arienti V,Antico E,Caspani B,Magnolfi F,Megna AS,Pretolani S,Regine R,Sponza M,Stasi R.Long-term outcome of cirrhotic patients with early hepatocellular carcinoma treated with ultrasound-guided percutaneous laser ablation:a retrospective analysis.J Clin Oncol2009;27:2615-2621[PMID:19332729 DOI:10.1200/JCO.2008.19.0082]
57 Chan AC,Cheung TT,Fan ST,Chok KS,Chan SC,Poon RT,Lo CM.Survival analysis of high-intensity focused ultrasound therapy versus radiofrequency ablation in the treatment of recurrent hepatocellular carcinoma.Ann Surg 2013;257:686-692[PMID:23426335 DOI:10.1097/SLA.0b013e3182822c02]
58 Cheung TT,Fan ST,Chan SC,Chok KS,Chu FS,Jenkins CR,Lo RC,Fung JY,Chan AC,Sharr WW,Tsang SH,Dai WC,Poon RT, Lo CM.High-intensity focused ultrasound ablation:an effective bridging therapy for hepatocellular carcinoma patients.World J Gastroenterol 2013;19:3083-3089[PMID:23716988 DOI:10 .3748/wjg.v19.i20.3083]
59 Ng KK,Poon RT,Chan SC,Chok KS,Cheung TT,Tung H,Chu F,Tso WK,Yu WC,Lo CM,Fan ST.High-intensity focused ultrasound for hepatocellular carcinoma:a single-center experience.Ann Surg 2011;253:981-987[PMID:21394012 DOI:10.1097/SLA.0b013e3182128a8b]
60 DupréA,Melodelima D,Pérol D,Chen Y,Vincenot J,Chapelon JY,Rivoire M.First clinical experience of intra-operative high intensity focused ultrasound in patients with colorectal liver metastases:a phase I-IIa study.PLo S One 2015;10:e0118212[PMID:25719540 DOI:10.1371/journal.pone.0118212}]
61 Gandini A,Melodelima D,Schenone F,N’Djin AW,Chapelon JY,Rivoire M.High-intensity focused ultrasound(HIFU)-assisted hepatic resection in an animal model.Ann Surg Oncol2012;19 Suppl 3:S447-S454[PMID:21796492 DOI:10.1245/s10434-011-1875-0]
62 Shibata T,Iimuro Y,Yamamoto Y,Maetani Y,Ametani F,Itoh K,Konishi J.Small hepatocellular carcinoma:comparison of radiofrequency ablation and percutaneous microwave coagulation therapy.Radiology 2002;223:331-337[PMID:11997534]
63 Yin XY,Xie XY,Lu MD,Xu HX,Xu ZF,Kuang M,Liu GJ,Liang JY,Lau WY.Percutaneous thermal ablation of medium and large hepatocellular carcinoma:long-term outcome and prognostic factors.Cancer 2009;115:1914-1923[PMID:19241423 DOI:10 .1002/cncr.24196]
64 Sato M,Watanabe Y,Ueda S,Iseki S,Abe Y,Sato N,Kimura S,Okubo K,Onji M.Microwave coagulation therapy for hepatocellular carcinoma.Gastroenterology 1996;110:1507-1514[PMID:8613057]
65 Itoh S,Ikeda Y,Kawanaka H,Okuyama T,Kawasaki K,Eguchi D,Korenaga D,Takenaka K.Efficacy of surgical microwave therapy in patients with unresectable hepatocellular carcinoma.Ann Surg Oncol 2011;18:3650-3656[PMID:21674268 DOI:10.1245/s10434 -011-1831-z]
66 Dong B,Liang P,Yu X,Su L,Yu D,Cheng Z,Zhang J.Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma:results in 234 patients.AJR Am J Roentgenol 2003;180:1547-1555[PMID:12760916]
67 Liang P,Dong B,Yu X,Yu D,Wang Y,Feng L,Xiao Q.Prognostic factors for survival in patients with hepatocellular carcinoma after percutaneous microwave ablation.Radiology 2005;235:299-307[PMID:15731369]
68 Seki S,Sakaguchi H,Iwai S,Kadoya H,Kabayashi S,Kitada T,Fujii H,Tanaka T.Five-year survival of patients with hepatocellular carcinoma treated with laparoscopic microwave coagulation therapy.Endoscopy 2005;37:1220-1225[PMID:16329021]
69 Abdelaziz AO,Nabeel MM,Elbaz TM,Shousha HI,Hassan EM,Mahmoud SH,Rashed NA,Ibrahim MM,Abdelmaksoud AH.Microwave ablation versus transarterial chemoembolization in large hepatocellular carcinoma:prospective analysis.Scand J Gastroenterol 2015;50:479-484[PMID:25592058 DOI:10.3109/00365521.2014.1003397]
70 Seifert JK,Morris DL.World survey on the complications of hepatic and prostate cryotherapy.World J Surg 1999;23:109-113;discussion 113-114[PMID:9880417]
71 Jungraithmayr W,Burger D,Olschewski M,Eggstein S.Cryoablation of malignant liver tumors:results of a single center study.Hepatobiliary Pancreat Dis Int 2005;4:554-560[PMID:16286261]
72 Davalos RV,Mir IL,Rubinsky B.Tissue ablation with irreversible electroporation.Ann Biomed Eng 2005;33:223-231[PMID:15771276]
73 Charpentier KP.Irreversible electroporation for the ablation of liver tumors:are we there yet?Arch Surg 2012;147:1053-1061[PMID:23165618 DOI:10.1001/2013.jamasurg.100]
74 Kingham TP,Karkar AM,D’Angelica MI,Allen PJ,Dematteo RP,Getrajdman GI,Sofocleous CT,Solomon SB,Jarnagin WR,Fong Y. Ablation of perivascular hepatic malignant tumors with irreversible electroporation.J Am Coll Surg 2012;215:379-387[PMID:22704820 DOI:10.1016/j.jamcollsurg.2012.04.029]
75 Cannon R,Ellis S,Hayes D,Narayanan G,Martin RC.Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures.J Surg Oncol 2013;107:544-549[PMID:23090720 DOI:10.1002/jso.23280]
76 Philips P,Hays D,Martin RC.Irreversible electroporation ablation(IRE)of unresectable soft tissue tumors:learning curve evaluation in the first 150 patients treated.PLo S One 2013;8:e76260[PMID:24223700 DOI:10.1371/journal.pone.0076260]
77 Narayanan G,Froud T,Lo K,Barbery KJ,Perez-Rojas E,Yrizarry J.Pain analysis in patients with hepatocellular carcinoma:irreversible electroporation versus radiofrequency ablation-initial observations.Cardiovasc Intervent Radiol 2013;36:176-182[PMID:22752100 DOI:10.1007/s00270-012-0426-9]
78 Niessen C,Igl J,Pregler B,Beyer L,Noeva E,Dollinger M,Schreyer AG,Jung EM,Stroszczynski C,Wiggermann P.Factors associated with short-term local recurrence of liver cancer after percutaneous ablation using irreversible electroporation:a prospective single-center study.J Vasc Interv Radiol 2015;26:694-702[PMID:25812712 DOI:10.1016/j.jvir.2015.02.001]
79 Llovet JM,Bruix J.Systematic review of randomized trials for unresectable hepatocellular carcinoma:Chemoembolization improves survival.Hepatology 2003;37:429-442[PMID:12540794]
80 Llovet JM,Real MI,Monta?a X,Planas R,Coll S,Aponte J,Ayuso C,Sala M,Muchart J,SolàR,Rodés J,Bruix J.Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma:a randomised controlled trial.Lancet 2002;359:1734-1739[PMID:12049862]
81 Lo CM,Ngan H,Tso WK,Liu CL,Lam CM,Poon RT,Fan ST,Wong J.Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma.Hepatology 2002;35:1164-1171[PMID:11981766]
82 A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma.Groupe d’Etude et de Traitement du Carcinome Hépatocellulaire.N Engl J Med 1995;332:1256-1261[PMID:7708069]
83 Bruix J,Llovet JM,Castells A,Monta?áX,BrúC,Ayuso MC,Vilana R,Rodés J.Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma:results of a randomized,controlled trial in a single institution.Hepatology 1998;27:1578-1583[PMID:9620330]
84 Lin DY,Liaw YF,Lee TY,Lai CM.Hepatic arterial embolization in patients with unresectable hepatocellular carcinoma--a randomized controlled trial.Gastroenterology 1988;94:453-456[PMID:2826285]
85 Pelletier G,Ducreux M,Gay F,Luboinski M,Hagège H,Dao T,Van Steenbergen W,Buffet C,Rougier P,Adler M,Pignon JP,Roche A.Treatment of unresectable hepatocellular carcinoma with lipiodol chemoembolization:a multicenter randomized trial.Groupe CHC.J Hepatol 1998;29:129-134[PMID:9696501]
86 Oliveri RS,Wetterslev J,Gluud C.Transarterial(chemo)embolisation for unresectable hepatocellular carcinoma.Cochrane Database Syst Rev 2011;3:CD004787[PMID:21412886 DOI:10 .1002/14651858.CD004787.pub2]
87 Varela M,Real MI,Burrel M,Forner A,Sala M,Brunet M,Ayuso C,Castells L,Monta?áX,Llovet JM,Bruix J.Chemoembolization of hepatocellular carcinoma with drug eluting beads:efficacy and doxorubicin pharmacokinetics.J Hepatol 2007;46:474-481[PMID:17239480]
88 Lammer J,Malagari K,Vogl T,Pilleul F,Denys A,Watkinson A,Pitton M,Sergent G,Pfammatter T,Terraz S,Benhamou Y,Avajon Y,Gruenberger T,Pomoni M,Langenberger H,Schuchmann M,Dumortier J,Mueller C,Chevallier P,Lencioni R.Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma:results of the PRECISION V study.Cardiovasc Intervent Radiol 2010;33:41-52[PMID:19908093 DOI:10.1007/s00270-009-9711-7]
89 Liu YS,Ou MC,Tsai YS,Lin XZ,Wang CK,Tsai HM,Chuang MT.Transarterial chemoembolization using gelatin sponges or microspheres plus lipiodol-doxorubicin versus doxorubicin-loaded beads for the treatment of hepatocellular carcinoma.Korean J Radiol 2015;16:125-132[PMID:25598680 DOI:10.3348/kjr.2015.16.1.125]
90 Deipolyi AR,Oklu R,Al-Ansari S,Zhu AX,Goyal L,Ganguli S.Safety and efficacy of 70-150μm and 100-300μm drug-eluting bead transarterial chemoembolization for hepatocellular carcinoma.J Vasc Interv Radiol 2015;26:516-522[PMID:25704226 DOI:10 .1016/j.jvir.2014.12.020]
91 Malagari K,Pomoni M,Kelekis A,Pomoni A,Dourakis S,Spyridopoulos T,Moschouris H,Emmanouil E,Rizos S,Kelekis D.Prospective randomized comparison of chemoembolization with doxorubicin-eluting beads and bland embolization with Bead Block for hepatocellular carcinoma.Cardiovasc Intervent Radiol 2010;33:541-551[PMID:19937027 DOI:10.1007/s00270-009-9750-0]
92 Ginsburg M,Zivin SP,Wroblewski K,Doshi T,Vasnani RJ,Van Ha TG.Comparison of combination therapies in the management of hepatocellular carcinoma:transarterial chemoembolization with radiofrequency ablation versus microwave ablation.J Vasc Interv Radiol 2015;26:330-341[PMID:25534635 DOI:10.1016/j.jvir.2014.10.047]
93 Iezzi R,Pompili M,La Torre MF,Campanale MC,Montagna M,Saviano A,Cesario V,Siciliano M,Annicchiarico E,Agnes S,Giuliante F,Grieco A,Rapaccini GL,De Gaetano AM,Gasbarrini A,Bonomo L.Radiofrequency ablation plus drug-eluting beads transcatheter arterial chemoembolization for the treatment of single large hepatocellular carcinoma.Dig Liver Dis 2015;47:242-248[PMID:25577299 DOI:10.1016/j.dld.2014.12.007]
94 Lencioni R,Llovet JM,Han G,Tak WY,Yang J,Leberre MA,Niu W,Nicholson K,Meinhardt G,Bruix J.Sorafenib or placebo in combination with transarterial chemoembolization(TACE)with doxorubicin-eluting beads(DEBDOX)for intermediate-stage hepatocellular carcinoma(HCC):phase II,randomized,doubleblind SPACE trial.J Clin Oncol 2012;30 Suppl 4:Abs LBA154
95 Geschwind JF,Salem R,Carr BI,Soulen MC,Thurston KG,Goin KA,Van Buskirk M,Roberts CA,Goin JE.Yttrium-90microspheres for the treatment of hepatocellular carcinoma.Gastroenterology 2004;127:S194-S205[PMID:15508085]
96 Salem R,Lewandowski RJ,Atassi B,Gordon SC,Gates VL,Barakat O,Sergie Z,Wong CY,Thurston KG.Treatment of unresectable hepatocellular carcinoma with use of 90Y microspheres(Thera Sphere):safety,tumor response,and survival.J Vasc Interv Radiol 2005;16:1627-1639[PMID:16371529]
97 Sangro B,Bilbao JI,Boan J,Martinez-Cuesta A,Benito A,Rodriguez J,Panizo A,Gil B,Inarrairaegui M,Herrero I,Quiroga J,Prieto J.Radioembolization using 90Y-resin microspheres for patients with advanced hepatocellular carcinoma.Int J Radiat Oncol Biol Phys 2006;66:792-800[PMID:16904840]
98 Salem R,Lewandowski RJ,Kulik L,Wang E,Riaz A,Ryu RK,Sato KT,Gupta R,Nikolaidis P,Miller FH,Yaghmai V,Ibrahim SM,Senthilnathan S,Baker T,Gates VL,Atassi B,Newman S,Memon K,Chen R,Vogelzang RL,Nemcek AA,Resnick SA,Chrisman HB,Carr J,Omary RA,Abecassis M,Benson AB,Mulcahy MF.Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma.Gastroenterology 2011;140:497-507.e2[PMID:21044630 DOI:10.1053/j.gastro.2010.10.049]
99 Llovet JM,Di Bisceglie AM,Bruix J,Kramer BS,Lencioni R,Zhu AX,Sherman M,Schwartz M,Lotze M,Talwalkar J,Gores GJ.Design and endpoints of clinical trials in hepatocellular carcinoma.J Natl Cancer Inst 2008;100:698-711[PMID:18477802 DOI:10 .1093/jnci/djn134]
100 Lee HS,Kim JS,Choi IJ,Chung JW,Park JH,Kim CY.The safety and efficacy of transcatheter arterial chemoembolization in the treatment of patients with hepatocellular carcinoma and main portal vein obstruction.A prospective controlled study.Cancer 1997;79:2087-2094[PMID:9179054]
101 Kim KM,Kim JH,Park IS,Ko GY,Yoon HK,Sung KB,Lim YS,Lee HC,Chung YH,Lee YS,Suh DJ.Reappraisal of repeated transarterial chemoembolization in the treatment of hepatocellular carcinoma with portal vein invasion.J Gastroenterol Hepatol 2009;24:806-814[PMID:19207681 DOI:10.1111/j.1440-1746.2008.05728.x]
102 Jang JW,Bae SH,Choi JY,Oh HJ,Kim MS,Lee SY,Kim CW,Chang UI,Nam SW,Cha SB,Lee YJ,Chun HJ,Choi BG,Byun JY,Yoon SK.A combination therapy with transarterial chemolipiodolization and systemic chemo-infusion for large extensive hepatocellular carcinoma invading portal vein in comparison with conservative management.Cancer Chemother Pharmacol 2007;59:9-15[PMID:16614848]
103 Yen FS,Wu JC,Kuo BI,Chiang JH,Chen TZ,Lee SD.Transcatheter arterial embolization for hepatocellular carcinoma with portal vein thrombosis.J Gastroenterol Hepatol 1995;10:237-240[PMID:7548796]
104 Song do S,Nam SW,Bae SH,Kim JD,Jang JW,Song MJ,Lee SW,Kim HY,Lee YJ,Chun HJ,You YK,Choi JY,Yoon SK.Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma.World J Gastroenterol 2015;21:2395-2404[PMID:25741147DOI:10.3748/wjg.v21.i8.2395]
105 Kim GA,Shim JH,Yoon SM,Jung J,Kim JH,Ryu MH,Ryoo BY,Kang YK,Lee D,Kim KM,Lim YS,Lee HC,Chung YH,Lee YS.Comparison of chemoembolization with and without radiation therapy and sorafenib for advanced hepatocellular carcinoma with portal vein tumor thrombosis:a propensity score analysis.J Vasc Interv Radiol 2015;26:320-329.e6[PMID:25612807 DOI:10.1016/j.jvir.2014.10.019]
106 Salem R,Lewandowski RJ,Mulcahy MF,Riaz A,Ryu RK,Ibrahim S,Atassi B,Baker T,Gates V,Miller FH,Sato KT,Wang E,Gupta R,Benson AB,Newman SB,Omary RA,Abecassis M,Kulik L.Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres:a comprehensive report of long-term outcomes.Gastroenterology 2010;138:52-64[PMID:19766639DOI:10.1053/j.gastro.2009.09.006]
107 I?arrairaegui M,Martinez-Cuesta A,Rodríguez M,Bilbao JI,Arbizu J,Benito A,Alegre F,D’Avola D,Herrero JI,Quiroga J,Prieto J,Sangro B.Analysis of prognostic factors after yttrium-90radioembolization of advanced hepatocellular carcinoma.Int J Radiat Oncol Biol Phys 2010;77:1441-1448[PMID:20056355DOI:10.1016/j.ijrobp.2009.07.006]
108 I?arrairaegui M,Thurston KG,Bilbao JI,D’Avola D,Rodriguez M,Arbizu J,Martinez-Cuesta A,Sangro B.Radioembolization with use of yttrium-90 resin microspheres in patients with hepatocellular carcinoma and portal vein thrombosis.J Vasc Interv Radiol 2010;21:1205-1212[PMID:20598574 DOI:10.1016/j.jvir.2010.04.012]
109 Hilgard P,Hamami M,Fouly AE,Scherag A,Müller S,Ertle J,Heusner T,Cicinnati VR,Paul A,Bockisch A,Gerken G,Antoch G.Radioembolization with yttrium-90 glass microspheres in hepatocellular carcinoma:European experience on safety and longterm survival.Hepatology 2010;52:1741-1749[PMID:21038413DOI:10.1002/hep.23944]
110 National Comprehensive Cancer Network.NCCN Clinical Practice Guidelines in Oncology.Hepatobiliary Cancers V.2.2010.[Accessed March15,2015]Available from:URL:http://www.nccn.org/professionals/physician_gls/f_guidelines.asp
