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肝动脉灌注化疗及肝动脉化疗栓塞在不可切除性肝细胞癌治疗中的现状及进展
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Abstract:
在不可切除性肝细胞癌的治疗方式中，局部治疗联合系统治疗是目前的主要治疗方式，但目前尚无统一的方案。近年来，肝动脉灌注化疗(Hepatic Arterial Infusion Chemotherapy, HAIC)和肝动脉化疗栓塞(Transcatheter Arterial Chemoembolization, TACE)已成为不可切除性肝癌治疗的主要手段之一。通过回顾近年来的文献和研究，本综述总结了HAIC和TACE在不可切除性肝癌中的应用现状及进展，重点介绍了两种方法的治疗机制、临床疗效、并发症及其联合治疗的新模式。
Among the treatment modalities for unresectable hepatocellular carcinoma, local therapy combined with systemic therapy is the main treatment modality at present, but there is no uniform protocol. In recent years, hepatic arterial infusion chemotherapy (HAIC) and transcatheter arterial chemoembolization (TACE) have become one of the main means of treatment for unresectable hepatocellular carcinoma. By reviewing the literature and studies in recent years, this review summarizes the current status and progress of the application of HAIC and TACE in unresectable hepatocellular carcinoma, focusing on the therapeutic mechanism, clinical efficacy, complications, and its new paradigm of combined treatment of the two approaches.
| [1] | Han, B., Zheng, R., Zeng, H., Wang, S., Sun, K., Chen, R., et al. (2024) Cancer Incidence and Mortality in China, 2022. Journal of the National Cancer Center, 4, 47-53. https://doi.org/10.1016/j.jncc.2024.01.006 |
| [2] | Villanueva, A. (2019) Hepatocellular Carcinoma. New England Journal of Medicine, 380, 1450-1462. https://doi.org/10.1056/nejmra1713263 |
| [3] | 中华人民共和国国家卫生健康委员会医政司. 原发性肝癌诊疗指南(2024年版) [J]. 中国实用外科杂志, 2024, 44(4): 361-386. |
| [4] | Chen, C., Liu, T., Shao, Y., Liu, K., Liang, P. and Lin, Z. (2021) Revisiting Hepatic Artery Infusion Chemotherapy in the Treatment of Advanced Hepatocellular Carcinoma. International Journal of Molecular Sciences, 22, Article 12880. https://doi.org/10.3390/ijms222312880 |
| [5] | Chow, P.K.H., Gandhi, M., Tan, S., Khin, M.W., Khasbazar, A., Ong, J., et al. (2018) SIRveNIB: Selective Internal Radiation Therapy versus Sorafenib in Asia-Pacific Patients with Hepatocellular Carcinoma. Journal of Clinical Oncology, 36, 1913-1921. https://doi.org/10.1200/jco.2017.76.0892 |
| [6] | Qin, S., Bai, Y., Lim, H.Y., Thongprasert, S., Chao, Y., Fan, J., et al. (2013) Randomized, Multicenter, Open-Label Study of Oxaliplatin Plus Fluorouracil/Leucovorin versus Doxorubicin as Palliative Chemotherapy in Patients with Advanced Hepatocellular Carcinoma from Asia. Journal of Clinical Oncology, 31, 3501-3508. https://doi.org/10.1200/jco.2012.44.5643 |
| [7] | Ghanaati, H., Mohammadifard, M. and Mohammadifard, M. (2021) A Review of Applying Transarterial Chemoembolization (TACE) Method for Management of Hepatocellular Carcinoma. Journal of Family Medicine and Primary Care, 10, 3553-3560. https://doi.org/10.4103/jfmpc.jfmpc_2347_20 |
| [8] | Peng, Z., Fan, W., Zhu, B., Wang, G., Sun, J., Xiao, C., et al. (2023) Lenvatinib Combined with Transarterial Chemoembolization as First-Line Treatment for Advanced Hepatocellular Carcinoma: A Phase III, Randomized Clinical Trial (Launch). Journal of Clinical Oncology, 41, 117-127. https://doi.org/10.1200/jco.22.00392 |
| [9] | Xia, D., Bai, W., Wang, E., Li, J., Chen, X., Wang, Z., et al. (2022) Lenvatinib with or without Concurrent Drug-Eluting Beads Transarterial Chemoembolization in Patients with Unresectable, Advanced Hepatocellular Carcinoma: A Real-World, Multicenter, Retrospective Study. Liver Cancer, 11, 368-382. https://doi.org/10.1159/000523849 |
| [10] | Ikeda, M., Arai, Y., Inaba, Y., Tanaka, T., Sugawara, S., Kodama, Y., et al. (2022) Conventional or Drug-Eluting Beads? Randomized Controlled Study of Chemoembolization for Hepatocellular Carcinoma: Jivrosg-1302. Liver Cancer, 11, 440-450. https://doi.org/10.1159/000525500 |
| [11] | Liu, Y., Lin, C., Chuang, M., Lin, C., Tsai, Y., Wang, C., et al. (2018) Five-Year Outcome of Conventional and Drug-Eluting Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma. BMC Gastroenterology, 18, Article No. 124. https://doi.org/10.1186/s12876-018-0848-1 |
| [12] | Shi, Z., Wang, D., Kang, T., Yi, R., Cui, L. and Jiang, H. (2023) Comparison of CalliSpheres Microspheres Drug-Eluting Beads and Conventional Transarterial Chemoembolization in Hepatocellular Carcinoma Patients: A Randomized Controlled Trial. Radiology and Oncology, 57, 70-79. https://doi.org/10.2478/raon-2023-0001 |
| [13] | Lee, E.W. and Khan, S. (2017) Recent Advances in Transarterial Embolotherapies in the Treatment of Hepatocellular Carcinoma. Clinical and Molecular Hepatology, 23, 265-272. https://doi.org/10.3350/cmh.2017.0111 |
| [14] | Salem, R., Lewandowski, R.J., Atassi, B., Gordon, S.C., Gates, V.L., Barakat, O., et al. (2005) Treatment of Unresectable Hepatocellular Carcinoma with Use of 90Y Microspheres (TheraSphere): Safety, Tumor Response, and Survival. Journal of Vascular and Interventional Radiology, 16, 1627-1639. https://doi.org/10.1097/01.rvi.0000184594.01661.81 |
| [15] | Shi, Z.X., Wang, D.Q., Kang, T.R., et al. (2023) Yttrium-90 Microspheres (TheraSphere) Treatment of Unresectable Hepatocellular Carcinoma: Downstaging to Resection, RFA and Bridge to Transplantation. https://pubmed.ncbi.nlm.nih.gov/17048240/ |
| [16] | Kennedy, A.S., Coldwell, D., Nutting, C., Murthy, R., Wertman, D.E., Loehr, S.P., et al. (2006) Resin 90y-Microsphere Brachytherapy for Unresectable Colorectal Liver Metastases: Modern USA Experience. International Journal of Radiation Oncology, Biology, Physics, 65, 412-425. https://doi.org/10.1016/j.ijrobp.2005.12.051 |
| [17] | Irie, T., Kuramochi, M. and Takahashi, N. (2012) Dense Accumulation of Lipiodol Emulsion in Hepatocellular Carcinoma Nodule during Selective Balloon-Occluded Transarterial Chemoembolization: Measurement of Balloon-Occluded Arterial Stump Pressure. Cardiovascular and Interventional Radiology, 36, 706-713. https://doi.org/10.1007/s00270-012-0476-z |
| [18] | Chang, Y., Jeong, S.W., Young Jang, J. and Jae Kim, Y. (2020) Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma. International Journal of Molecular Sciences, 21, Article 8165. https://doi.org/10.3390/ijms21218165 |
| [19] | 夏银锋. 经动脉化疗栓塞(TACE)联合经动脉灌注化疗(HAIC)对比单纯TACE治疗不可切除肝癌的疗效及安全性[J]. 临床医学进展, 2023, 13(5): 8156-8162. |
| [20] | Huang, Z., Wu, Z., Zhang, L., Yan, L., Jiang, H. and Ai, J. (2024) The Safety and Efficacy of TACE Combined with HAIC, PD-1 Inhibitors, and Tyrosine Kinase Inhibitors for Unresectable Hepatocellular Carcinoma: A Retrospective Study. Frontiers in Oncology, 14, Article 1298122. https://doi.org/10.3389/fonc.2024.1298122 |
| [21] | Pang, B., Zuo, B., Huang, L., You, X., Liu, T., Hao, J., et al. (2024) Real-World Efficacy and Safety of TACE-HAIC Combined with TKIs and PD-1 Inhibitors in Initially Unresectable Hepatocellular Carcinoma. International Immunopharmacology, 137, Article 112492. https://doi.org/10.1016/j.intimp.2024.112492 |
| [22] | Yuan, Y., He, W., Yang, Z., Qiu, J., Huang, Z., Shi, Y., et al. (2023) TACE-HAIC Combined with Targeted Therapy and Immunotherapy versus TACE Alone for Hepatocellular Carcinoma with Portal Vein Tumour Thrombus: A Propensity Score Matching Study. International Journal of Surgery, 109, 1222-1230. https://doi.org/10.1097/js9.0000000000000256 |
| [23] | Zhao, W., Liu, C., Wu, Y., Yao, Z., Dou, Q., Li, W., et al. (2024) Transarterial Chemoembolization (TACE)-Hepatic Arterial Infusion Chemotherapy (HAIC) Combined with PD-1 Inhibitors Plus Lenvatinib as a Preoperative Conversion Therapy for Nonmetastatic Advanced Hepatocellular Carcinoma: A Single Center Experience. Translational Cancer Research, 13, 2315-2331. https://doi.org/10.21037/tcr-24-93 |
| [24] | He, M., Li, Q., Zou, R., Shen, J., Fang, W., Tan, G., et al. (2019) Sorafenib Plus Hepatic Arterial Infusion of Oxaliplatin, Fluorouracil, and Leucovorin vs Sorafenib Alone for Hepatocellular Carcinoma with Portal Vein Invasion. JAMA Oncology, 5, 953-960. https://doi.org/10.1001/jamaoncol.2019.0250 |
| [25] | Li, S., Mei, J., Cheng, Y., Li, Q., Wang, Q., Fang, C., et al. (2023) Postoperative Adjuvant Hepatic Arterial Infusion Chemotherapy with FOLFOX in Hepatocellular Carcinoma with Microvascular Invasion: A Multicenter, Phase III, Randomized Study. Journal of Clinical Oncology, 41, 1898-1908. https://doi.org/10.1200/jco.22.01142 |
| [26] | 中国抗癌协会肝癌专业委员会. 肝动脉灌注化疗治疗肝细胞癌中国专家共识(2021版)[J]. 中华消化外科杂志, 2021, 20(7): 754-759. |
| [27] | 王洁, 李含英, 吕展杨, 等. 肝动脉灌注化疗的围手术期护理[J]. 介入放射学杂志, 2024, 33(4): 431-437. |
| [28] | 李文兰, 李文博. 原发性肝癌病人经肝动脉持续灌注化疗的护理研究进展[J]. 全科护理, 2024, 22(10): 1853-1856. |
| [29] | 张雯, 周永杰, 颜志平. 再论精细tace[J]. 介入放射学杂志, 2021, 30(10): 971-975. |
| [30] | 杜楠, 王英, 李文涛. 肝癌tace还是haic? [J]. 介入放射学杂志, 2024, 33(12): 1269-1273. |
| [31] | Ge, N., Wang, H., He, C., Wang, X., Huang, J. and Yang, Y. (2023) Optimal Interventional Treatment for Liver Cancer: HAIC, TACE or iTACE? Journal of Interventional Medicine, 6, 59-63. https://doi.org/10.1016/j.jimed.2023.03.001 |
