Department of Surgery, UT Southwestern Medical Center, Dallas, TX 75390-8548, USA.
HPB (Oxford). 2010 Jun;12(5):313-20. doi: 10.1111/j.1477-2574.2010.00183.x.
Although surgical resection and liver transplantation are the only treatment modalities that enable prolonged survival in patients with hepatocellular carcinoma (HCC), the majority of HCC patients presents with advanced disease and do not undergo resective or ablative therapy. Transarterial chemoembolization (TACE) is indicated in intermediate/advanced stage unresectable HCC even in the setting of portal vein involvement (excluding main portal vein). Sorafenib has been shown to improve survival of patients with advanced HCC in two controlled randomized trials. Yttrium 90 is a safe microembolization treatment that can be used as an alternative to TACE in patients with advanced liver only disease or in case of portal vein thrombosis. External beam radiation can be helpful to provide local control in selected unresectable HCC. These different treatment modalities may be combined in the treatment strategy of HCC and also used as a bridge to resection or liver transplantation. Patients should undergo formal multidisciplinary evaluation prior to initiating any such treatment in order to individualize the best available options.
尽管手术切除和肝移植是使肝细胞癌 (HCC) 患者获得长期生存的唯一治疗方法，但大多数 HCC 患者患有晚期疾病，无法进行切除或消融治疗。即使门静脉受累（不包括主门静脉），经动脉化疗栓塞 (TACE) 也适用于中/晚期不可切除的 HCC。两项对照随机试验表明，索拉非尼可改善晚期 HCC 患者的生存。钇 90 是一种安全的微栓塞治疗方法，可在晚期仅有肝脏疾病或门静脉血栓形成的患者中替代 TACE 使用。外照射放疗有助于对选定的不可切除 HCC 提供局部控制。这些不同的治疗方法可以联合用于 HCC 的治疗策略，也可以作为切除或肝移植的桥梁。在开始任何此类治疗之前，患者应接受正式的多学科评估，以便为每个患者制定最佳的治疗方案。
