Fatourou Evangelia M, Tsochatzis Emmanuel A
1 Liver Unit, St. Mary's Hospital, London, UK ; 2 Sheila Sherlock Liver Unit and UCL Institute of Liver and Digestive Health, Royal Free Hospital, London, UK.
Hepatobiliary Surg Nutr. 2014 Dec;3(6):415-8. doi: 10.3978/j.issn.2304-3881.2014.07.01.
Intermediate stage hepatocellular carcinoma (HCC) comprises of a highly heterogeneous patient population, both in terms of liver function and tumour burden. Transarterial chemoembolization (TACE) is the treatment of choice for this subgroup of patients, provided that liver function is relatively preserved. Not all patients respond to an initial session of TACE, and further session might impair liver function. The ART score consists of an increase of AST >25%, increase of Child-Pugh of one or two points and absence of radiological tumour response and helps identify patients that would not benefit from further TACE sessions. We critically appraise the use of this score, particularly in terms of patient selection and timing of calculation of its variables. Once sufficiently validated, it can become a safe, objective and accurate clinical tool in everyday practice.
中期肝细胞癌（HCC）患者群体高度异质，在肝功能和肿瘤负荷方面均是如此。经动脉化疗栓塞术（TACE）是该亚组患者的首选治疗方法，前提是肝功能相对良好。并非所有患者对首次TACE治疗均有反应，进一步治疗可能会损害肝功能。ART评分包括AST升高>25%、Child-Pugh评分增加1分或2分以及无放射学肿瘤反应，有助于识别无法从进一步TACE治疗中获益的患者。我们对该评分的应用进行了批判性评估，特别是在患者选择和其变量计算时机方面。一旦得到充分验证，它可成为日常实践中安全、客观且准确的临床工具。
