Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road. 1277, Wuhan, 430022, People's Republic of China.
J Cancer Res Clin Oncol. 2011 Dec;137(12):1763-72. doi: 10.1007/s00432-011-1026-9. Epub 2011 Sep 11.
Liver metastases are the major cause of mortality in patients with gastrointestinal carcinomas and other malignant tumors, carrying a poor prognosis and presenting considerable management. Surgical resection remains the only curative therapy for liver metastases up to now. However, only a small percentage of patients are suitable for curative resection due to many factors: multi-centric tumors, extrahepatic metastases, early vascular invasion, and coexisting advanced liver cirrhosis. In non-surgical cases, regional interventional therapies have led to a major break through in the treatment of unresectable liver metastases, which include transarterial chemoembolization (TACE), radiofrequency ablation (RFA), laser-induced thermotherapy (LITT), cryosurgical ablation (CSA), microwave coagulation therapy (MCT), percutaneous ethanol injection (PEI), and others. As a result of the technical development of locoregional approaches for unresectable liver metastases during recent decades, the range of combined interventional therapies has been continuously enlarged. The current roles of these treatment options for liver metastases are discussed in this review.
肝转移是胃肠道癌和其他恶性肿瘤患者死亡的主要原因,预后不良,治疗管理难度大。手术切除仍然是目前治疗肝转移的唯一治愈性疗法。然而,由于多种因素,只有一小部分患者适合进行治愈性切除:多中心肿瘤、肝外转移、早期血管侵犯和并存的晚期肝硬化。在非手术情况下,区域介入治疗在不可切除的肝转移治疗方面取得了重大突破,包括经动脉化疗栓塞术(TACE)、射频消融术(RFA)、激光诱导热疗(LITT)、冷冻消融术(CSA)、微波凝固治疗(MCT)、经皮乙醇注射(PEI)等。由于近几十年来针对不可切除肝转移的局部区域方法的技术发展,联合介入治疗的范围不断扩大。本文讨论了这些肝转移治疗选择的当前作用。