Hong Kelvin, Georgiades Christos S, Geschwind Jean-Francois H
Division of Interventional Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Nat Clin Pract Oncol. 2006 Jun;3(6):315-24. doi: 10.1038/ncponc0512.
Locoregional techniques have become the mainstay of therapy for patients with unresectable hepatocellular carcinoma (HCC). Such image-guided interventions include catheter-based approaches (transarterial chemoembolization and yttrium-90 radiotherapy) and locoregional ablative techniques, either chemical (percutaneous ethanol injection), or thermal (radiofrequency ablation, laser ablation, microwave ablation and cryoablation). These therapies are mainly utilized for palliation, but have also been used with curative intent. In selected cases, percutaneous interventional treatments have shown good results (5-year survival 40-50%), but, even when chosen as first-line treatment, have not been able to achieve the response rates and outcomes achieved by surgical options (resection or transplantation). New promising image-guided therapies are continuously emerging, as we attempt to improve tumor targeting, minimize hepatic toxicity and ultimately improve quality of life and survival of patients with HCC. With new technologies in imaging and drug delivery becoming available, it is likely that, in the future, patients with HCC will be best treated by a multidisciplinary team approach, utilizing a combination of techniques to improve patient survival. This review outlines the current status of the most commonly used image-guided locoregional interventions in the treatment of patients with HCC, and describes recent research and advances related to image-guided interventions for liver cancer.
局部区域技术已成为不可切除肝细胞癌（HCC）患者治疗的主要手段。此类影像引导下的干预措施包括基于导管的方法（经动脉化疗栓塞和钇-90放疗）以及局部区域消融技术，化学消融（经皮乙醇注射）或热消融（射频消融、激光消融、微波消融和冷冻消融）。这些治疗主要用于姑息治疗，但也用于根治性治疗。在某些病例中，经皮介入治疗已显示出良好的效果（5年生存率为40%-50%），但即使作为一线治疗选择，也未能达到手术治疗（切除或移植）所取得的缓解率和治疗效果。随着我们试图改善肿瘤靶向性、将肝毒性降至最低并最终提高HCC患者的生活质量和生存率，新的有前景的影像引导治疗方法不断涌现。随着成像和药物递送新技术的出现，未来HCC患者很可能最好通过多学科团队方法进行治疗，利用多种技术组合来提高患者生存率。本综述概述了HCC患者治疗中最常用的影像引导局部区域干预措施的现状，并描述了与肝癌影像引导干预相关的最新研究和进展。
