Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.
Expert Rev Anticancer Ther. 2014 Aug;14(8):931-45. doi: 10.1586/14737140.2014.911091. Epub 2014 Apr 19.
Locally ablative therapies have an increasing role in the effective multidisciplinary approach towards the treatment of both primary and metastatic liver tumors. In patients who are not considered surgical candidates and have low volume disease, these therapies have now become established into consensus practice guidelines. A large range of therapeutic options exist including percutaneous ethanol injection (PEI), radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation, percutaneous laser ablation (PLA), irreversible electroporation (IRE), stereotactic body radiation therapy (SBRT) and high intensity focused ultrasound (HIFU); each having benefits and drawbacks. The greatest body of evidence supporting clinical utility in the liver currently exists for RFA, with PEI having fallen out of favor. MWA, IRE, SBRT and HIFU are relatively nascent technologies, and outcomes data supporting their use is promising. Future directions of ablative therapies include tandem approaches to improve efficacy in the treatment of liver tumors.
局部消融治疗在原发性和转移性肝肿瘤的有效多学科治疗方法中发挥着越来越重要的作用。对于那些不符合手术条件且肿瘤体积较小的患者,这些治疗方法现已成为共识实践指南。存在大量治疗选择,包括经皮乙醇注射(PEI)、射频消融(RFA)、微波消融(MWA)、冷冻消融、经皮激光消融(PLA)、不可逆电穿孔(IRE)、立体定向体部放射治疗(SBRT)和高强度聚焦超声(HIFU);每种方法都有其优点和缺点。目前,RFA 是在肝脏中具有临床实用性的最大证据支持,而 PEI 已不再流行。MWA、IRE、SBRT 和 HIFU 是相对新兴的技术,支持其使用的结果数据很有前景。消融治疗的未来发展方向包括采用串联方法来提高肝肿瘤治疗的效果。