射频消融联合其他介入综合技术治疗原发性肝癌研究进展
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摘要
原发性肝癌(HCC)死亡率居全球第三位,而中国肝癌患者的年发病及死亡病例数均超过全球总数的50%。目前,手术仍是唯一有可能治愈HCC的首选方法,但绝大多数患者发现时已为肝癌中晚期,失去了手术机会。近年来介入微创治疗已成为不可手术切除肝癌治疗的研究热点之一,主要包括:肝动脉化疗栓塞(TACE)、局部消融治疗、放射性粒子组织间近距离放疗及体外高能聚焦超声波等。由于介入微创治疗方式多样,如何合理有序的联合应用仍是当前的研究热点。本文重点综述以射频消融为基础的各种介入综合技术手段联合应用治疗肝癌的新进展。
The mortality rate of primary liver cancer(HCC) ranks third in the world, while the annual incidence and mortality of hepatocellular carcinoma patients in China are more than 50% of the global average.At present, surgery is still the only method that may cure HCC, but the majority of patients have no chance of surgery when found to be in the advanced stage. In recent years, interventional minimally invasive treatment has become one of the hotspots for the treatment of unresectable liver cancer, including transcatheter arterial chemoembolization(TACE), local ablation therapy, brachytherapy between radioactive particles, and highintensity focused ultrasound in vitro. Due to the variety of interventional minimally invasive treatment methods,how to use rational and orderly joint application is still the current research hotspot. This article mainly focuses on the new advances in the application of various interventional integrated techniques based on radiofrequency ablation for the treatment of liver cancer.
The mortality rate of primary liver cancer(HCC) ranks third in the world, while the annual incidence and mortality of hepatocellular carcinoma patients in China are more than 50% of the global average.At present, surgery is still the only method that may cure HCC, but the majority of patients have no chance of surgery when found to be in the advanced stage. In recent years, interventional minimally invasive treatment has become one of the hotspots for the treatment of unresectable liver cancer, including transcatheter arterial chemoembolization(TACE), local ablation therapy, brachytherapy between radioactive particles, and highintensity focused ultrasound in vitro. Due to the variety of interventional minimally invasive treatment methods,how to use rational and orderly joint application is still the current research hotspot. This article mainly focuses on the new advances in the application of various interventional integrated techniques based on radiofrequency ablation for the treatment of liver cancer.
引文
[1]Torre L A,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.
[2]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[3]Chen K,Chen G,Wang H,et al.Increased survival in hepatocellular carcinoma with iodine-125 implantation plus radiofrequency ablation:a prospective randomized controlled trial[J].J Hepatol,2014,61(6):1304-1311.
[4]Crocetti L,de Baere T,Lencioni R.Quality improvement guidelines for radiofrequency ablation of liver tumours[J].Cardiovasc Intervent Radiol,2010,33(1):11-17.
[5]Lee MW.Comments on"Small hepatocellular carcinoma:is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment?"[J].Radiology,2010,254(2):633;author reply 634.
[6]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.
[7]Seror O,N'Kontchou G,Ibraheem M,et al.Large(>or=5.0-cm)HCCs:multipolar RF ablation with three internally cooled bipolar electrodes-initial experience in 26 patients[J].Radiology,2008,248(1):288-296.
[8]Tateishi R,Shiina S,Akahane M,et al.Frequency,risk factors and survival associated with an intrasubsegmental recurrence after radiofrequency ablation for hepatocellular carcinoma[J].PLoSONE,2013,8(4):e59040.
[9]Peng ZW,Zhang YJ,Chen MS,et al.Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma:a prospective randomized trial[J].JClin Oncol,2013,31(4):426-432.
[10]Dohmen K,Shirahama M,Shigematsu H,et al.Transcatheter arterial chemoembolization therapy combined with percutaneous ethanol injection for unresectable large hepatocellular carcinoma:an evaluation of the local therapeutic effect and survival rate[J].Hepatogastroenterology,2001,48(41):1409-1415.
[11]Kim JH,Won HJ,Shin YM,et al.Medium-sized(3.1-5.0 cm)hepatocellular carcinoma:transarterial chemoembolization plus radiofrequency ablation versus radiofrequency ablation alone[J].Ann Surg Oncol,2011,18(6):1624-1629.
[12]Morimoto M,Numata K,Kondou M,et al.Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma:a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization[J].Cancer,2010,116(23):5452-5460.
[13][13]Ji J,Gao J,Zhao L,et al.Computed tomography-guided radiofrequency ablation following transcatheter arterial embolization intreatment of large hepatic hemangiomas[J].Medicine(Baltimore),2016,95(15):e3402.
[14]Ji J,Gao J,Zhao L,et al.Computed Tomography-Guided Radiofrequency Ablation Following Transcatheter Arterial Embolization in Treatment of Large Hepatic Hemangiomas[J].Medicine,2016,95(15):e3402.
[15]Guo YJ,Huang WS,Zhou B et al.Transarterial chemoembolization plus computed tomography-guided percutaneous radiofrequency ablation for small hepatocellular carcinoma in special locations[J].Zhonghua Yi Xue Za Zhi,2013,93(33):2627-2630.
[16]Toshimori J,Nouso K,Nakamura S,et al.Local recurrence and complications after percutaneous radiofrequency ablation of hepatocellular carcinoma:a retrospective cohort study focused on tumor location[J].Acta Med Okayama,2015,69(4):219-226.
[17]Chen L,Sun J,Yang X.Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma:Current status[J].Cancer Lett,2016,370(1):78-84.
[18]Sakr AA,Saleh AA,Moeaty AA,et al.The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma[J].Eur J Radiol,2005,54(3):418-425.
[19]Li Z,Zhang K,Lin SM,et al.Radiofrequency ablation combined with percutaneous ethanol injection for hepatocellular carcinoma:a systematic review and meta-analysis[J].Int J Hyperthermia,2016:1-10.
[20]Zhu ZX,Liao MH,Wang XX,et al.Radiofrequency ablation with or without ethanol injection for hepatocellular carcinoma:a systematic review and meta-analysis[J].Minerva Med,2016,107(6):381-391.
[21]Wong SN,Lin CJ,Lin CC,et al.Combined percutaneous radiofrequency ablation and ethanol injection for hepatocellular carcinoma in high-risk locations[J].AJR Am J Roentgenol,2008,190(3):W187-W195.
[22]Kurokohchi K,Watanabe S,Masaki T,et al.Comparison between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma[J].World J Gastroenterol,2005,11(10):1426-1432.
[23]Kurokohchi K,Masaki T,Watanabe S,et al.Time-lag performance of radiofrequency ablation after percutaneous ethanol injection for the treatment of hepatocellular carcinoma[J].Int J Oncol,2006,28(4):971-976.
[24]Shrimal A,Prasanth M,Kulkarni AV.Interventional radiological treatment of hepatocellular carcinoma:an update[J].Indian J Surg,2012,74(1):91-99.
[25]Boerman OC,Koppe MJ,Postema EJ,et al.Radionuclide therapy of cancer with radiolabeled antibodies[J].Anticancer Agents Med Chem,2007,7(3):335-343.
[26]Tu J,Ji J,Wu F,et al.Effectiveness of combined(131)I-chTNTand radiofrequency ablation therapy in treating advanced hepatocellular carcinoma[J].Cell Biochem Biophys,2015,71(2):777-784.
[27]Rousse C,Chauvet B.Recommendations for inspections of the French nuclear safety authority[J].Cancer Radiother,2015,19(6-7):634-637.
[28]Zhongmin W,Yu L,Fenju L,et al.Clinical efficacy of CT-guided iodine-125 seed implantation therapy in patients with advanced pancreatic cancer[J].European Radiology,2010,20(7):1786-1791.
[29]Li C,Zhang F,Zhang W,et al.Feasibility of(125)I brachytherapy combined with sorafenib treatment in patients with multiple lung metastases after liver transplantation for hepatocellular carcinoma[J].J Cancer Res Clin Oncol,2010,136(11):1633-1640.
[30]Peng S,Yang QX,Zhang T,et al.Lobaplatin-TACE combined with radioactive 125I seed implantation for treatment of primary hepatocellular carcinoma[J].Asian Pac J Cancer Prev,2014,15(13):5155-5160.
[31]Tu JF,Xu HH,Ying XH,et al.Comparative study of several microinvasive treatments for large hepatocellular carcinoma[J].Eur Rev Med Pharmacol Sci,2015,19(1):45-53.
[32]Santambrogio R,Chiang J,Barabino M,et al.Comparison of Laparoscopic Microwave to Radiofrequency Ablation of Small Hepatocellular Carcinoma(≤3 cm)[J].Ann Surg Oncol,2017,24(1):257-263.
[33]Ginsburg M,Zivin SP,Wroblewski K,et al.Comparison of combination therapies in the management of hepatocellular carcinoma:transarterial chemoembolization with radiofrequency ablation versus microwave ablation[J].J Vasc Interv Radiol,2015,26(3):330-341.
[34]Vogl TJ,Farshid P,Naguib NN,et al.Ablation therapy of hepatocellular carcinoma:a comparative study between radiofrequency and microwave ablation[J].Abdom Imaging,2015,40(6):1829-1837.
[35]Lencioni R,de Baere T,Martin RC,et al.Image-guided ablation of malignant liver tumors:Recommendations for clinical validation of novel thermal and non-thermal technologies-a western perspective[J].Liver Cancer,2015,4(4):208-214.
[36]de Baere T,Deschamps F.New tumor ablation techniques for cancer treatment(microwave,electroporation)[J].Diagn Interv Imaging,2014,95(7-8):677-682.
[37]Sheta E,El-Kalla F,El-Gharib M,et al.Comparison of singlesession transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma:a randomized-controlled study[J].Eur JGastroenterol Hepatol,2016,28(10):1198-1203.
[38]Lee KF,Wong J,Hui JW,et al.Long-term outcomes of microwave versus radiofrequency ablation for hepatocellular carcinoma by surgical approach:A retrospective comparative study[J].Asian JSurg,2017,40(4):301-308.
[39]Facciorusso A,Di Maso M,Muscatiello N.Microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma:A systematic review and meta-analysis[J].Int JHyperthermia,2016,32(3):339-344.
[40]Ierardi AM,Floridi C,Fontana F,et al.Microwave ablation of liver metastases to overcome the limitations of radiofrequency ablation[J].Radiol Med,2013,118(6):949-961.
[41]Correa-Gallego C,Fong Y,Gonen M,et al.A retrospective comparison of microwave ablation vs.radiofrequency ablation for colorectal cancer hepatic metastases[J].Ann Surg Oncol,2014,21(13):4278-4283.
[42]Zhou Y,Zhao Y,Li B,et al.Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma[J].BMC Gastroenterol,2010,10:78.
[43]Choi D,Lim HK,Rhim H,et al.Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment:long-term results and prognostic factors in a large singleinstitution series[J].Eur Radiol,2007,17(3):684-692.
[44]Choi D,Lim HK,Joh JW,et al.Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas:long-term follow-up results and prognostic factors[J].Ann Surg Oncol,2007,14(12):3510-3518.
[45]Choi D,Lim HK,Rhim H.Concurrent and subsequent radiofrequency ablation combined with hepatectomy for hepatocellular carcinomas[J].World J Gastrointest Surg,2010,2(4):137-142.
[2]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[3]Chen K,Chen G,Wang H,et al.Increased survival in hepatocellular carcinoma with iodine-125 implantation plus radiofrequency ablation:a prospective randomized controlled trial[J].J Hepatol,2014,61(6):1304-1311.
[4]Crocetti L,de Baere T,Lencioni R.Quality improvement guidelines for radiofrequency ablation of liver tumours[J].Cardiovasc Intervent Radiol,2010,33(1):11-17.
[5]Lee MW.Comments on"Small hepatocellular carcinoma:is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment?"[J].Radiology,2010,254(2):633;author reply 634.
[6]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.
[7]Seror O,N'Kontchou G,Ibraheem M,et al.Large(>or=5.0-cm)HCCs:multipolar RF ablation with three internally cooled bipolar electrodes-initial experience in 26 patients[J].Radiology,2008,248(1):288-296.
[8]Tateishi R,Shiina S,Akahane M,et al.Frequency,risk factors and survival associated with an intrasubsegmental recurrence after radiofrequency ablation for hepatocellular carcinoma[J].PLoSONE,2013,8(4):e59040.
[9]Peng ZW,Zhang YJ,Chen MS,et al.Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma:a prospective randomized trial[J].JClin Oncol,2013,31(4):426-432.
[10]Dohmen K,Shirahama M,Shigematsu H,et al.Transcatheter arterial chemoembolization therapy combined with percutaneous ethanol injection for unresectable large hepatocellular carcinoma:an evaluation of the local therapeutic effect and survival rate[J].Hepatogastroenterology,2001,48(41):1409-1415.
[11]Kim JH,Won HJ,Shin YM,et al.Medium-sized(3.1-5.0 cm)hepatocellular carcinoma:transarterial chemoembolization plus radiofrequency ablation versus radiofrequency ablation alone[J].Ann Surg Oncol,2011,18(6):1624-1629.
[12]Morimoto M,Numata K,Kondou M,et al.Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma:a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization[J].Cancer,2010,116(23):5452-5460.
[13][13]Ji J,Gao J,Zhao L,et al.Computed tomography-guided radiofrequency ablation following transcatheter arterial embolization intreatment of large hepatic hemangiomas[J].Medicine(Baltimore),2016,95(15):e3402.
[14]Ji J,Gao J,Zhao L,et al.Computed Tomography-Guided Radiofrequency Ablation Following Transcatheter Arterial Embolization in Treatment of Large Hepatic Hemangiomas[J].Medicine,2016,95(15):e3402.
[15]Guo YJ,Huang WS,Zhou B et al.Transarterial chemoembolization plus computed tomography-guided percutaneous radiofrequency ablation for small hepatocellular carcinoma in special locations[J].Zhonghua Yi Xue Za Zhi,2013,93(33):2627-2630.
[16]Toshimori J,Nouso K,Nakamura S,et al.Local recurrence and complications after percutaneous radiofrequency ablation of hepatocellular carcinoma:a retrospective cohort study focused on tumor location[J].Acta Med Okayama,2015,69(4):219-226.
[17]Chen L,Sun J,Yang X.Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma:Current status[J].Cancer Lett,2016,370(1):78-84.
[18]Sakr AA,Saleh AA,Moeaty AA,et al.The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma[J].Eur J Radiol,2005,54(3):418-425.
[19]Li Z,Zhang K,Lin SM,et al.Radiofrequency ablation combined with percutaneous ethanol injection for hepatocellular carcinoma:a systematic review and meta-analysis[J].Int J Hyperthermia,2016:1-10.
[20]Zhu ZX,Liao MH,Wang XX,et al.Radiofrequency ablation with or without ethanol injection for hepatocellular carcinoma:a systematic review and meta-analysis[J].Minerva Med,2016,107(6):381-391.
[21]Wong SN,Lin CJ,Lin CC,et al.Combined percutaneous radiofrequency ablation and ethanol injection for hepatocellular carcinoma in high-risk locations[J].AJR Am J Roentgenol,2008,190(3):W187-W195.
[22]Kurokohchi K,Watanabe S,Masaki T,et al.Comparison between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma[J].World J Gastroenterol,2005,11(10):1426-1432.
[23]Kurokohchi K,Masaki T,Watanabe S,et al.Time-lag performance of radiofrequency ablation after percutaneous ethanol injection for the treatment of hepatocellular carcinoma[J].Int J Oncol,2006,28(4):971-976.
[24]Shrimal A,Prasanth M,Kulkarni AV.Interventional radiological treatment of hepatocellular carcinoma:an update[J].Indian J Surg,2012,74(1):91-99.
[25]Boerman OC,Koppe MJ,Postema EJ,et al.Radionuclide therapy of cancer with radiolabeled antibodies[J].Anticancer Agents Med Chem,2007,7(3):335-343.
[26]Tu J,Ji J,Wu F,et al.Effectiveness of combined(131)I-chTNTand radiofrequency ablation therapy in treating advanced hepatocellular carcinoma[J].Cell Biochem Biophys,2015,71(2):777-784.
[27]Rousse C,Chauvet B.Recommendations for inspections of the French nuclear safety authority[J].Cancer Radiother,2015,19(6-7):634-637.
[28]Zhongmin W,Yu L,Fenju L,et al.Clinical efficacy of CT-guided iodine-125 seed implantation therapy in patients with advanced pancreatic cancer[J].European Radiology,2010,20(7):1786-1791.
[29]Li C,Zhang F,Zhang W,et al.Feasibility of(125)I brachytherapy combined with sorafenib treatment in patients with multiple lung metastases after liver transplantation for hepatocellular carcinoma[J].J Cancer Res Clin Oncol,2010,136(11):1633-1640.
[30]Peng S,Yang QX,Zhang T,et al.Lobaplatin-TACE combined with radioactive 125I seed implantation for treatment of primary hepatocellular carcinoma[J].Asian Pac J Cancer Prev,2014,15(13):5155-5160.
[31]Tu JF,Xu HH,Ying XH,et al.Comparative study of several microinvasive treatments for large hepatocellular carcinoma[J].Eur Rev Med Pharmacol Sci,2015,19(1):45-53.
[32]Santambrogio R,Chiang J,Barabino M,et al.Comparison of Laparoscopic Microwave to Radiofrequency Ablation of Small Hepatocellular Carcinoma(≤3 cm)[J].Ann Surg Oncol,2017,24(1):257-263.
[33]Ginsburg M,Zivin SP,Wroblewski K,et al.Comparison of combination therapies in the management of hepatocellular carcinoma:transarterial chemoembolization with radiofrequency ablation versus microwave ablation[J].J Vasc Interv Radiol,2015,26(3):330-341.
[34]Vogl TJ,Farshid P,Naguib NN,et al.Ablation therapy of hepatocellular carcinoma:a comparative study between radiofrequency and microwave ablation[J].Abdom Imaging,2015,40(6):1829-1837.
[35]Lencioni R,de Baere T,Martin RC,et al.Image-guided ablation of malignant liver tumors:Recommendations for clinical validation of novel thermal and non-thermal technologies-a western perspective[J].Liver Cancer,2015,4(4):208-214.
[36]de Baere T,Deschamps F.New tumor ablation techniques for cancer treatment(microwave,electroporation)[J].Diagn Interv Imaging,2014,95(7-8):677-682.
[37]Sheta E,El-Kalla F,El-Gharib M,et al.Comparison of singlesession transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma:a randomized-controlled study[J].Eur JGastroenterol Hepatol,2016,28(10):1198-1203.
[38]Lee KF,Wong J,Hui JW,et al.Long-term outcomes of microwave versus radiofrequency ablation for hepatocellular carcinoma by surgical approach:A retrospective comparative study[J].Asian JSurg,2017,40(4):301-308.
[39]Facciorusso A,Di Maso M,Muscatiello N.Microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma:A systematic review and meta-analysis[J].Int JHyperthermia,2016,32(3):339-344.
[40]Ierardi AM,Floridi C,Fontana F,et al.Microwave ablation of liver metastases to overcome the limitations of radiofrequency ablation[J].Radiol Med,2013,118(6):949-961.
[41]Correa-Gallego C,Fong Y,Gonen M,et al.A retrospective comparison of microwave ablation vs.radiofrequency ablation for colorectal cancer hepatic metastases[J].Ann Surg Oncol,2014,21(13):4278-4283.
[42]Zhou Y,Zhao Y,Li B,et al.Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma[J].BMC Gastroenterol,2010,10:78.
[43]Choi D,Lim HK,Rhim H,et al.Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment:long-term results and prognostic factors in a large singleinstitution series[J].Eur Radiol,2007,17(3):684-692.
[44]Choi D,Lim HK,Joh JW,et al.Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas:long-term follow-up results and prognostic factors[J].Ann Surg Oncol,2007,14(12):3510-3518.
[45]Choi D,Lim HK,Rhim H.Concurrent and subsequent radiofrequency ablation combined with hepatectomy for hepatocellular carcinomas[J].World J Gastrointest Surg,2010,2(4):137-142.