Chung Jin Wook, Choi Dongil
Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.
Korean J Gastroenterol. 2005 Apr;45(4):258-70.
In spite of the nice screening program using the state-of-the-art imaging modalities, most patients with hepatocellular carcinoma (HCC) are not eligible for curative resection due to poor hepatic functional reserve and multiplicity of the tumors. Therefore they greatly rely on percutaneous interventional procedures. Among these, transcatheter arterial chemoembolization and local ablation therapies including ethanol injection therapy or radiofrequency (RF) thermal ablation have gained wider acceptance for the local treatment of unresectable HCC with growing evidence of survival gain. Although we need more prospective randomized trials to determine the definite role of these interventional therapies, the current consensus is that they are safe and effective for the local control of small HCC and have a potential to replace definitive surgical options. In this review, the basic principles and published clinical results including long-term survival rates and complications are reviewed. The benefits and limitations of each therapy are also discussed.
尽管采用了最先进的成像方式进行了良好的筛查计划，但由于肝功能储备差和肿瘤的多发性，大多数肝细胞癌（HCC）患者不符合根治性切除的条件。因此，他们非常依赖经皮介入治疗。其中，经导管动脉化疗栓塞术和局部消融治疗，包括乙醇注射治疗或射频（RF）热消融术，在不可切除HCC的局部治疗中得到了更广泛的认可，越来越多的证据表明其可提高生存率。尽管我们需要更多的前瞻性随机试验来确定这些介入治疗的确切作用，但目前的共识是，它们对于小肝癌的局部控制是安全有效的，并且有可能取代确定性的手术选择。在这篇综述中，我们回顾了基本原则以及已发表的临床结果，包括长期生存率和并发症。还讨论了每种治疗方法的益处和局限性。
