de Baere Thierry, Tselikas Lambros, Deschamps Frederic, Boige Valerie, Ducreux Michel, Hollebecque Antoine
Department of Image Guided Therapy, Gustave Roussy-Cancer Campus, Villejuif, France.
Université Paris-Sud XI, UFR Médecine Le Kremlin-Bicêtre, Le Kremlin Bicêtre, France.
Hepat Oncol. 2016 Apr;3(2):109-118. doi: 10.2217/hep-2015-0001. Epub 2016 Mar 23.
Conventional transarterial chemoembolization (c-TACE) was validated in 2002 for intermediate stage hepatocellular carcinoma (HCC). Recent improvements in overall survival after c-TACE in HCC is linked to both better patient selection, and improvement in treatment technologies: catheter, image guidance and new drug delivery platforms. Drug eluting beads (DEBs) demonstrated a benefit over c-TACE in pharmacokinetic studies; however, two randomized studies comparing c-TACE and DEB-TACE demonstrated no benefit of DEB-TACE in response rate or overall survival. Delivery platforms loaded with yttrium-90 deliver selective internal radiation therapy, which opens a new field of therapy for HCC. Future improvement in intra-arterial therapies will include resorbable loadable embolic material, new emulsion used for c-TACE and platforms releasing multikinase inhibitors.
传统经动脉化疗栓塞术（c-TACE）于2002年被证实可用于中期肝细胞癌（HCC）。近期HCC患者接受c-TACE治疗后总生存期的改善与更好的患者选择以及治疗技术的进步有关，这些技术包括导管、影像引导和新的药物递送平台。药物洗脱微球（DEB）在药代动力学研究中显示出优于c-TACE的效果；然而，两项比较c-TACE和DEB-TACE的随机研究表明，DEB-TACE在缓解率或总生存期方面并无优势。负载钇-90的递送平台可提供选择性内放射治疗，这为HCC开辟了一个新的治疗领域。动脉内治疗未来的改进将包括可吸收的可装载栓塞材料、用于c-TACE的新型乳剂以及释放多激酶抑制剂的平台。
