Li Guangfu, Staveley-O'Carroll Kevin F, Kimchi Eric T
Department of Surgery, University of Missouri, Columbia, MO 65212, USA; Ellis Fischel Cancer Center, University of Missouri, Columbia, MO 65212, USA.
Department of Surgery, University of Missouri, Columbia, MO 65212, USA; Ellis Fischel Cancer Center, University of Missouri, Columbia, MO 65212, USA; Department of Molecular Microbiology and Immunology, University of Missouri, Columbia, MO 65212, USA.
J Clin Trials. 2016 Apr;6(2). doi: 10.4172/2167-0870.1000257. Epub 2016 Apr 5.
Radiofrequency ablation (RFA) is an important treatment option for patients with early hepatocellular carcinoma (HCC). RFA offers a reliable, reproducible modality to effectively treat hepatic lesions with minimal collateral damage to the surrounding hepatic parenchyma. In addition to traditional open operative techniques, RFA can be performed percutaneously or laparoscopically to minimize the physiologic insult to the patient. Due to the concomitant hepatic damage and dysfunction that often is present in patients with HCC these factors make RFA a frequently utilized therapeutic option. However, RFA is most efficacious in treating smaller tumors (≤ 2 cm), particularly when an ablation margin of ≥ 4-5 mm can be obtained. RFA has diminishing utility in larger tumors, resulting in reduced three and five year overall survival rates when compared to surgical resection. Multimodal approaches to include RFA with other standard and investigational approaches have become a subject of recent interest. RFA capably produces cellular destruction causing liberation of a substantial amount of antigens, many of which are tumor-specific providing a favorable environment for immune recognition. We propose that utilizing an immunotherapeutic approach in conjunction with RFA is the next logical step in the treatment of HCC. In this review, we summarize how RFA modulates antitumor immunity and works in concert with immunotherapy in the treatment of HCC. The information provided is expected to help the future design of novel RFA-integrated immunotherapies which are able to generate durable and powerful antitumor immune response to achieve optimal tumor control.
射频消融（RFA）是早期肝细胞癌（HCC）患者的重要治疗选择。RFA提供了一种可靠、可重复的方式，能有效治疗肝脏病变，同时对周围肝实质的附带损伤最小。除了传统的开放手术技术外，RFA还可以经皮或腹腔镜进行，以尽量减少对患者的生理损伤。由于HCC患者常伴有肝损伤和功能障碍，这些因素使得RFA成为一种常用的治疗选择。然而，RFA在治疗较小肿瘤（≤2 cm）时最为有效，特别是当能够获得≥4-5 mm的消融边缘时。RFA在较大肿瘤中的效用逐渐降低，与手术切除相比，其三年和五年总生存率降低。包括RFA与其他标准和研究方法在内的多模式方法已成为近期关注的主题。RFA能够产生细胞破坏，导致大量抗原释放，其中许多是肿瘤特异性的，为免疫识别提供了有利环境。我们认为，将免疫治疗方法与RFA联合使用是HCC治疗的下一步合理举措。在本综述中，我们总结了RFA如何调节抗肿瘤免疫以及在HCC治疗中如何与免疫治疗协同作用。所提供的信息有望有助于未来设计新型的RFA联合免疫疗法，这种疗法能够产生持久而强大的抗肿瘤免疫反应，以实现最佳的肿瘤控制。
