Li David, Kang Josephine, Golas Benjamin J, Yeung Vincent W, Madoff David C
1 Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, USA ; 2 Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA ; 3 Flushing Radiation Oncology Services, Flushing, New York, NY 11354, USA ; 4 Department of Surgery, Division of Surgical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center New York, New York, NY 10065, USA.
Cancer Biol Med. 2014 Dec;11(4):217-36. doi: 10.7497/j.issn.2095-3941.2014.04.001.
Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have filled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.
原发性和转移性肝肿瘤正日益成为一个全球性的健康问题，肝细胞癌（HCC）目前是全球癌症相关死亡的第三大主要原因。HCC的全身治疗选择仍然有限，索拉非尼是唯一经前瞻性验证可提高总生存期的药物。手术切除和/或移植、局部消融治疗以及区域或局部区域治疗填补了肝肿瘤治疗的空白，为原发性和转移性肿瘤均提供了改善的生存结果。微创局部治疗在原发性和转移性肝肿瘤的治疗中发挥着越来越重要的作用。对于疾病体积较小的患者，这些治疗方法现已被纳入共识实践指南。本综述重点介绍了常用的微创局部治疗的技术方面和结果，包括腹腔镜肝切除术（LLR）、射频消融（RFA）、微波消融（MWA）、高强度聚焦超声（HIFU）、不可逆电穿孔（IRE）和立体定向体部放射治疗（SBRT）。此外，还综述了利用这些微创技术的联合治疗策略的作用。
