Department of Interventional Radiology, First Affiliated Hospital of Soochow University, 188 Shizi Street, 215006, Suzhou, Jiangsu, People's Republic of China.
Abdom Radiol (NY). 2019 Jun;44(6):2268-2275. doi: 10.1007/s00261-019-01943-2.
To review the current status and ideal time interval of the combination therapy of transarterial chemoembolization (TACE) and local ablation for patients with HCCs.
In recent years, local ablation has been proposed as an alternative curative treatment in the management of HCC. Additionally, many treatment options are available including TACE molecular targeted agents and immune checkpoint inhibitors. Similar overall survival rates and prognoses have been obtained with radiofrequency ablation (RFA) microwave ablation (MWA) and cryoablation for patients with HCCs up to 3 cm in diameter. Yet, MWA has shown superiority in treating large HCCs while cryoablation has several advantages compared with RFA or MWA. Furthermore, the treatment strategy of TACE combined with local ablation is widely accepted by many physicians in order to further increase the survival rate and improve the prognosis of patients with HCCs. However, the time interval between the two sessions of combination therapy remains uncertain in the current guidelines. Combination therapy of TACE and local ablation has advantages on survival and prognosis in patients with HCC compared with monotherapy. Good patient selection for the right modality needs to be carried out to guarantee the most efficacious treatment for HCC patients. Further studies are needed to find the ideal time interval between TACE and local ablation for HCC patients.
讨论经动脉化疗栓塞（TACE）联合局部消融治疗肝细胞癌（HCC）的现状和理想间隔时间。
近年来，局部消融已被提议作为 HCC 治疗的一种替代根治性治疗方法。此外，有许多治疗选择，包括 TACE 分子靶向药物和免疫检查点抑制剂。对于直径不超过 3cm 的 HCC 患者，射频消融（RFA）、微波消融（MWA）和冷冻消融的总生存率和预后相似。然而，MWA 在治疗大 HCC 方面具有优势，而冷冻消融与 RFA 或 MWA 相比具有几个优势。此外，TACE 联合局部消融的治疗策略被许多医生广泛接受，以进一步提高 HCC 患者的生存率和改善预后。然而，目前指南中仍不确定两种联合治疗方案之间的时间间隔。与单独治疗相比，TACE 联合局部消融治疗 HCC 患者在生存和预后方面具有优势。需要对患者进行良好的选择，以保证对 HCC 患者进行最有效的治疗。需要进一步的研究来确定 HCC 患者 TACE 和局部消融之间的理想间隔时间。
