肝动脉内定向治疗：介入肿瘤学的作用。
Intraarterial Liver-Directed Therapies: The Role of Interventional Oncology.
作者信息
Ma Jenson, Gimenez Juan Martin, Sandow Tyler, Devun Daniel, Kirsch David, Gulotta Paul, Gilbert Patrick, Kay Dennis
机构信息
Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA.
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
出版信息
Ochsner J. 2017 Winter;17(4):412-416.
BACKGROUND
Since the early 1990s, the minimally invasive image-guided therapies used in interventional oncology to treat hepatocellular carcinoma have continued to evolve. Additionally, the range of applications has been expanded to the treatment of hepatic metastases from colorectal cancer, neuroendocrine tumors, cholangiocarcinoma, breast cancer, melanoma, and sarcoma.
METHODS
We searched the literature to identify publications from 1990 to the present on various image-guided intraarterial therapies and their efficacy, as well as their role in the management of primary and secondary liver malignancies.
RESULTS
Chemoembolization and radioembolization are considered a standard of care in treating, delaying progression of disease, and downstaging to bridge to liver transplantation. Progression-free survival and overall survival outcomes are promising in patients with colorectal cancer and neuroendocrine tumors with liver metastases. Applications in the treatment of hepatic metastases from cholangiocarcinoma, breast cancer, melanoma, and sarcoma also show potential.
CONCLUSION
Interventional oncology and its image-guided intraarterial therapies continue to gain recognition as treatment options for primary and secondary liver cancers. Growing evidence supports their role as a standard of care alongside medical oncology, surgery, and radiation oncology.
背景
自20世纪90年代初以来，介入肿瘤学中用于治疗肝细胞癌的微创影像引导治疗不断发展。此外，其应用范围已扩大到治疗结直肠癌、神经内分泌肿瘤、胆管癌、乳腺癌、黑色素瘤和肉瘤的肝转移。
方法
我们检索文献，以确定1990年至今关于各种影像引导下动脉内治疗及其疗效，以及它们在原发性和继发性肝脏恶性肿瘤管理中的作用的出版物。
结果
化疗栓塞和放射性栓塞被认为是治疗、延缓疾病进展以及降期以过渡到肝移植的标准治疗方法。无进展生存期和总生存期结果在患有肝转移的结直肠癌和神经内分泌肿瘤患者中很有前景。在胆管癌、乳腺癌、黑色素瘤和肉瘤肝转移治疗中的应用也显示出潜力。
结论
介入肿瘤学及其影像引导下动脉内治疗作为原发性和继发性肝癌的治疗选择，继续获得认可。越来越多的证据支持它们与医学肿瘤学、外科手术和放射肿瘤学一起作为标准治疗方法的作用。
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