原发性肝癌治疗方法的应用进展
摘要
原发性肝癌目前的治疗方案有手术治疗、局部消融、经肝动脉化疗栓塞术、放射治疗、药物治疗和免疫疗法等。腹腔镜下肝切除术的外科术式发展迅速,适应证范围逐渐拓宽,是肝癌患者的首选治疗方法;局部消融广泛使用于早期肝癌,但肿瘤消融率不佳;经肝动脉化疗栓塞术是标准的非手术治疗方案,提高了无法手术切除肝癌患者的生存率,但其栓塞后综合征常见;外照射和内照射治疗为肝转移癌患者提供了一种选择,能延长晚期肝癌患者的生存时间;分子靶向药物、化疗药物、中药和抗病毒药都能延缓肝癌的疾病进展;抗CTLA-4和PD-1/PD-L1抗体现正处于治疗肝癌的热点研究。虽然单个治疗方法效果不太理想,但多个治疗方案的联合应用可以有效延长患者的生存时间,而且就未来的治疗前景而言,肿瘤免疫治疗给肝癌带来了新思路。
引文
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[3] Gagner M. Pioneers in laparoscopic solid organ surgery[J]. Surg Endosc, 2003,17(11):1853-1854.
[4] Tsai KY, Chen HA, Wang WY, et al. Long-term and short-term surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma: might laparoscopic approach be better in early HCC[J]. Surg Endosc, 2018,6(5):7-15.
[5] Packiam V, Bartlett DL, Tohme S, et al. Minimally invasive liver resection: robotic versus laparoscopic left lateral sectionectomy[J]. J Gastrointest Surg, 2012,16(12):2233-2238.
[6] Mazzaferro V, Bhoori S, Sposito C, et al. Milan criteria in liver transplantation for hepatocellular carcinoma: an evidence-based analysis of 15 years of experience[J]. Liver Transpl, 2011,17(2):44-57.
[7] Ma KW, Chok KSH, Fung JYY, et al. Liver transplantation for hepatitis B virus-related hepatocellular carcinoma in Hong Kong[J]. JCTH, 2018,6(7):283-288.
[8] Hasegawa K, Aoki T, Ishizawa T, et al. Comparison of the therapeutic outcomes between surgical resection and percutaneous ablation for small hepatocellular carcinoma[J]. Ann Surg Oncol, 2014,21(3):348-355.
[9] Hsu JC, Tsai HL, Lin YL, et al. Acute pericarditis following treatment of a metastatic liver tumor with radiofrequency ablation: a case report[J]. BMC Cardiovasc Disor, 2018,18(200):1-5.
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[12] Di Vece F, Tombesi P, Ermili F, et al. Coagulation areas produced by cool-tip radiofrequency ablation and microwave ablation using a device to decrease back-heating effects: a prospective pilot study[J]. Cardiovasc Intervent Radiol, 2014,37(3):723-729.
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[25] Webster DP, Klenerman P, Dusheiko GM. Hepatitis C[J]. The Lancet, 2015,385(9973):1124-1135.
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