Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy.
Department of Radiology, IRCSS Fatebenefratelli Hospital, Roma 00186, Italy.
World J Gastroenterol. 2019 Aug 28;25(32):4614-4628. doi: 10.3748/wjg.v25.i32.4614.
Liver cancers are the second most frequent cause of global cancer-related mortality of which 90% are attributable to hepatocellular carcinoma (HCC). Despite the advent of screening programmes for patients with known risk factors, a substantial number of patients are ineligible for curative surgery at presentation with limited outcomes achievable with systemic chemotherapy/external radiotherapy. This has led to the advent of numerous minimally invasive options including but not limited to trans-arterial chemoembolization, radiofrequency/microwave ablation and more recently selective internal radiation therapy many of which are often the first-line treatment for select stages of HCC or serve as a conduit to liver transplant. The authors aim to provide a comprehensive overview of these various image guided minimally invasive therapies with a brief focus on the technical aspects accompanied by a critical analysis of the literature to assess the most up-to-date evidence from comparative systematic reviews and meta-analyses finishing with an assessment of novel combination regimens and future directions of travel.
肝癌是全球癌症相关死亡的第二大主要原因，其中 90%归因于肝细胞癌 (HCC)。尽管针对已知危险因素的患者开展了筛查计划，但仍有相当数量的患者在就诊时不符合根治性手术的条件，全身性化疗/外部放疗的效果有限。这导致了许多微创选择的出现，包括但不限于经动脉化疗栓塞、射频/微波消融术，以及最近的选择性内放射治疗，其中许多通常是 HCC 特定阶段的一线治疗方法，或作为肝移植的桥梁。作者旨在全面概述这些各种图像引导微创治疗方法，并简要关注技术方面，同时批判性地分析文献，以评估来自比较系统评价和荟萃分析的最新证据，最后评估新的联合治疗方案和未来的发展方向。
