Department of Radiation Oncology, Stanford Cancer Institute, Stanford, CA.
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Semin Radiat Oncol. 2018 Oct;28(4):295-308. doi: 10.1016/j.semradonc.2018.08.001.
Surgical resection or liver transplantation offers the best chance of cure for patients with hepatocellular carcinoma (HCC). Unfortunately, most patients are not good candidates for liver resection due to locally advanced disease or compromised liver function. Moreover, liver transplantation waiting lists are long. For those cases not amenable for resection, a variety of local treatment modalities are available, such as image-guided ablative procedures, transarterial chemoembolization, and radioembolization, as well as external beam radiation. HCC presentation can vary considerably in size, number, and location of lesions. The management of inoperable HCC is, therefore, quite complex, and there is a lack of consensus on the best local treatment modality for each type tumor presentation. Here, we present 4 clinical case scenarios representative of commonly seen cases in the clinical setting, with different therapeutic perspectives from institutions with high expertise in the management of HCC.
手术切除或肝移植为肝细胞癌 (HCC) 患者提供了治愈的最佳机会。不幸的是，由于局部晚期疾病或肝功能受损，大多数患者不适合进行肝切除术。此外，肝移植等待名单很长。对于那些不适合切除的病例，可以使用多种局部治疗方法，如影像引导的消融治疗、经动脉化疗栓塞和放射性栓塞，以及外照射。HCC 的表现可以在肿瘤的大小、数量和位置上有很大的差异。因此，无法手术的 HCC 的治疗非常复杂，对于每种肿瘤表现的最佳局部治疗方法，目前尚无共识。在这里，我们提出了 4 个具有代表性的临床病例场景，这些场景代表了临床实践中常见的病例，来自具有 HCC 管理专业知识的机构的不同治疗观点。
