Gnutzmann Daniel, Kortes Nikolas, Sumkauskaite Migle, Schmitz Anne, Weiss Karl-Heinz, Radeleff Boris
a Department of Diagnostic and Interventional Radiology , Hospital Konstanz , Konstanz , Germany.
b Department of Diagnostic and Interventional Radiology , Sana Clinic Hof , Hof , Germany.
Minim Invasive Ther Allied Technol. 2018 Apr;27(2):69-80. doi: 10.1080/13645706.2018.1432489. Epub 2018 Jan 30.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Only 30-40% of patients diagnosed with HCC are candidates for curative treatment options. The remaining majority of patients undergo local, regional or systemic palliative therapies. Transvascular therapy of HCC takes advantage of the fact that hypervascularized HCCs receive their main perfusion from the hepatic artery. In this context transvascular therapy describes different therapies: bland embolization (transarterial embolization, TAE), cTACE (conventional transarterial chemoembolization), DEB-TACE (TACE with drug-eluting beads, DEB) and SIRT (selective internal radiation therapy, radioembolization). cTACE is the most common type of transvascular treatment and represents a combination of the intra-arterial use of a chemotherapeutic agent and embolization. There is no standardized regimen for cTACE. It remains unclear whether the intra-arterial application of a chemotherapeutic agent is definitely required, because bland embolization alone using very small spherical particles shows tumor necrosis comparable to cTACE. For DEB-TACE microparticles loaded with a chemotherapeutic drug combine the advantages of cTACE and bland embolization.
肝细胞癌（HCC）是全球第五大常见癌症。确诊为HCC的患者中，只有30%-40%适合进行根治性治疗。其余大多数患者接受局部、区域或全身姑息治疗。HCC的经血管治疗利用了高血供的HCC主要从肝动脉获得灌注这一事实。在此背景下，经血管治疗描述了不同的治疗方法：单纯栓塞（经动脉栓塞，TAE）、传统经动脉化疗栓塞（cTACE）、载药微球经动脉化疗栓塞（DEB-TACE，即使用载药微球的TACE）和选择性内放射治疗（SIRT，即放射性栓塞）。cTACE是最常见的经血管治疗类型，它是动脉内使用化疗药物与栓塞的结合。cTACE没有标准化方案。目前尚不清楚动脉内应用化疗药物是否绝对必要，因为单独使用非常小的球形颗粒进行单纯栓塞显示出与cTACE相当的肿瘤坏死效果。对于DEB-TACE，载有化疗药物的微球结合了cTACE和单纯栓塞的优点。
