Lu Jian, Zhong Bin-Yan, Zhu Hai-Dong, Guo Jin-He, Teng Gao-Jun
Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China.
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Chin Clin Oncol. 2019 Dec;8(6):60. doi: 10.21037/cco.2019.11.01. Epub 2019 Dec 9.
Asia suffers a particularly large prevalence of the world's hepatocellular carcinoma (HCC), accounting for nearly 72.5% of the newly diagnosed 609,596 cases and 72.4% of the 566,269 deaths. The majority of HCC patients is diagnosed at unresectable stages in Asia despite efforts to improve availability of screening. Although the Barcelona Clinic Liver Cancer (BCLC) staging algorithm is accepted worldwide, various staging systems and guidelines have been proposed in Asian regions. Embolotherapy has been endorsed by many Asian guidelines and is the most common treatment across all stages of HCC. There are considerable discrepancies of the allocation of embolotherapy for unresectable HCC in Asia. This review will focus on the indication and contraindication, technique variances, combination regimen, and when to start, repeat or stop embolotherapy for unresectable HCC with the hope to provide insights into TACE application to patients at any HCC stage.
亚洲肝细胞癌(HCC)的患病率在全球尤为突出,新诊断的609,596例病例中占近72.5%,在566,269例死亡病例中占72.4%。尽管努力提高筛查的可及性,但亚洲大多数肝癌患者在不可切除阶段才被诊断出来。尽管巴塞罗那临床肝癌(BCLC)分期算法在全球被接受,但亚洲地区已提出了各种分期系统和指南。栓塞治疗已得到许多亚洲指南的认可,是肝癌各阶段最常用的治疗方法。亚洲在不可切除肝癌的栓塞治疗分配上存在相当大的差异。本综述将聚焦于不可切除肝癌栓塞治疗的适应证和禁忌证、技术差异、联合方案以及何时开始、重复或停止栓塞治疗,希望能为在肝癌任何阶段的患者应用经动脉化疗栓塞术(TACE)提供见解。