Department of Oncology, UCL Medical School, Royal Free Campus, London, UK.
J Hepatol. 2012 Mar;56(3):686-95. doi: 10.1016/j.jhep.2011.07.031. Epub 2011 Oct 2.
Hepatocellular cancer is a significant global health problem yet the prognosis for the majority of patients has not changed significantly over the past few decades. For patients with advanced disease, sorafenib is currently the standard of care providing a survival advantage of 2-3 months in selected patients. Cytotoxic chemotherapy has been used for over 30 years but definite evidence that it prolongs survival has been lacking. Resistance remains a significant barrier for both targeted and cytotoxic agents and an understanding of the underlying mechanisms is critical if outcomes are to be improved. Here, we summarise the past and current data that constitute the evidence base for chemotherapy in HCC, review the causes of chemoresistance and suggest strategies to overcome these barriers.
肝细胞癌是一个全球性的重大健康问题，但在过去几十年中，大多数患者的预后并未显著改善。对于晚期疾病患者，索拉非尼目前是标准治疗方法，可在选定的患者中提供 2-3 个月的生存优势。细胞毒性化疗已使用了 30 多年，但缺乏明确证据表明它能延长生存时间。耐药性仍然是靶向和细胞毒性药物的一个重大障碍，如果要改善治疗效果，了解其潜在机制至关重要。在这里，我们总结了构成 HCC 化疗证据基础的过去和当前数据，回顾了化疗耐药的原因，并提出了克服这些障碍的策略。
