Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, 76 Yanta West Road, Xi'an 710061, People's Republic of China.
Med Oncol. 2013 Mar;30(1):381. doi: 10.1007/s12032-012-0381-y. Epub 2013 Jan 6.
Many non-surgical treatments of hepatocellular carcinoma (HCC) have significantly improved in the last few decades and have shown survival benefits for selected patients with HCC. Today ablation can improve survival in individuals diagnosed in early HCC and even offer a curative treatment in selected candidates. Patients with intermediate-stage HCC benefit from transarterial chemoembolization (TACE). Drug-eluting bead transarterial chemoembolization (DEB-TACE) has shown a better combined ischemic and cytotoxic effect locally and less system toxicity when compared with conventional TACE. Those diagnosed at advanced stage benefit from sorafenib. In addition to TACE and sorafenib which could improve survival for selected patients, three-dimensional conformal radiotherapy treatment (3-DCRT), selection internal radiation therapy and systemic chemotherapy have also shown anti-tumor activity in the treatment of advanced HCC, but their survival benefit have not been proven. The limited effects of single therapy suggested that the combination would enhance the overall treatment effect. Other potential non-surgical therapies like gene therapy and immunotherapy are still in testing phases, except for some small-scale clinical trials which have been reported to show some beneficial effect. Here, we review the current non-surgical treatments in HCC and the new advances in this field.
在过去几十年中，许多非手术治疗肝细胞癌（HCC）的方法有了显著改善，并为部分 HCC 患者带来了生存获益。如今，消融治疗可改善早期 HCC 患者的生存，甚至在某些特定患者中可实现治愈。中期 HCC 患者受益于经动脉化疗栓塞术（TACE）。与传统 TACE 相比，载药微球 TACE（DEB-TACE）显示出更好的局部缺血和细胞毒性联合作用，且全身毒性更小。晚期 HCC 患者则受益于索拉非尼。除了 TACE 和索拉非尼可改善部分患者的生存外，三维适形放疗（3-DCRT）、选择性内放射治疗和全身化疗在晚期 HCC 的治疗中也显示出抗肿瘤活性，但尚未证明其生存获益。单一疗法的疗效有限表明联合治疗可增强整体治疗效果。其他潜在的非手术治疗方法，如基因治疗和免疫疗法仍处于试验阶段，除了一些已报道显示出一定有益效果的小规模临床试验。在此，我们对 HCC 的现有非手术治疗方法和该领域的新进展进行综述。
