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原发性肝癌经动脉化疗栓塞术的最新进展。

Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma.

机构信息

Department of Internal Medicine, Digestive Disease Center, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul 04401, Korea.

Department of Radiology, Soonchunhyang University College of Medicine, Seoul 04401, Korea.

出版信息

Int J Mol Sci. 2020 Oct 31;21(21):8165. doi: 10.3390/ijms21218165.


DOI:10.3390/ijms21218165
PMID:33142892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7662786/
Abstract

Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). In this review, we summarize recent updates on the use of TACE for HCC. TACE can be performed using two techniques; conventional TACE (cTACE) and drug-eluting beads using TACE (DEB-TACE). The anti-tumor effect of the two has been reported to be similar; however, DEB-TACE carries a higher risk of hepatic artery and biliary injuries and a relatively lower risk of post-procedural pain than cTACE. TACE can be used for early stage HCC if other curative treatments are not feasible or as a neoadjuvant treatment before liver transplantation. TACE can also be considered for selected patients with limited portal vein thrombosis and preserved liver function. When deciding to repeat TACE, the ART (Assessment for Retreatment with TACE) score and ABCR (AFP, BCLC, Child-Pugh, and Response) score can guide the decision process, and TACE refractoriness needs to be considered. Studies on the combination therapy of TACE with other treatment modalities, such as local ablation, radiation therapy, or systemic therapy, have been actively conducted and are still ongoing. Recently, new prognostic models, including analysis of the neutrophil-lymphocyte ratio, radiomics, and deep learning, have been developed to help predict survival after TACE.

摘要

经动脉化疗栓塞术(TACE)是治疗中期肝细胞癌(HCC)的标准治疗方法。在这篇综述中,我们总结了 TACE 治疗 HCC 的最新进展。TACE 可以使用两种技术进行:传统 TACE(cTACE)和载药微球 TACE(DEB-TACE)。这两种方法的抗肿瘤效果相似,但 DEB-TACE 发生肝动脉和胆管损伤的风险较高,术后疼痛的风险相对较低。如果其他治愈性治疗方法不可行,或作为肝移植前的新辅助治疗,TACE 可用于早期 HCC。TACE 也可考虑用于有限门静脉血栓形成和保留肝功能的选定患者。决定重复 TACE 时,可以使用 ART(TACE 再治疗评估)评分和 ABCR(AFP、BCLC、Child-Pugh 和反应)评分来指导决策过程,并需要考虑 TACE 抵抗。TACE 与局部消融、放射治疗或系统治疗等其他治疗方式联合治疗的研究正在积极进行中。最近,已经开发了新的预后模型,包括中性粒细胞-淋巴细胞比值分析、放射组学和深度学习,以帮助预测 TACE 后的生存情况。

相似文献

[1]
Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma.

Int J Mol Sci. 2020-10-31

[2]
Comparison of lipiodol infusion and drug-eluting beads transarterial chemoembolization of hepatocellular carcinoma in a real-life setting.

Scand J Gastroenterol. 2019-7

[3]
Imaging Changes and Clinical Complications After Drug-Eluting Bead Versus Conventional Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: Multicenter Study.

AJR Am J Roentgenol. 2021-10

[4]
Comprehensive predictive factors for CalliSpheres® microspheres (CSM) drug-eluting bead-transarterial chemoembolization and conventional transarterial chemoembolization on treatment response and survival in hepatocellular carcinoma patients.

Clin Res Hepatol Gastroenterol. 2021-3

[5]
Conventional transarterial chemoembolization versus drug-eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma.

BMC Cancer. 2015-6-10

[6]
Liver and biliary damages following transarterial chemoembolization of hepatocellular carcinoma: comparison between drug-eluting beads and lipiodol emulsion.

Eur Radiol. 2017-4

[7]
Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety.

BMC Cancer. 2019-11-29

[8]
Conventional Versus Small Doxorubicin-eluting Bead Transcatheter Arterial Chemoembolization for Treating Barcelona Clinic Liver Cancer Stage 0/A Hepatocellular Carcinoma.

Cardiovasc Intervent Radiol. 2019-10-23

[9]
CalliSpheres drug-eluting beads versus lipiodol transarterial chemoembolization in the treatment of hepatocellular carcinoma: a short-term efficacy and safety study.

World J Surg Oncol. 2018-3-27

[10]
Five-year outcome of conventional and drug-eluting transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.

BMC Gastroenterol. 2018-8-3

引用本文的文献

[1]
Efficacy and Safety Analysis of Transarterial Chemoembolization Combined with Sintilimab Plus Bevacizumab Biosimilar in the Treatment of Unresectable Hepatocellular Carcinoma.

J Hepatocell Carcinoma. 2025-8-27

[2]
Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma: survival outcomes and prognostic factors from a systematic review and meta-analysis.

Hepatobiliary Surg Nutr. 2025-8-1

[3]
Longitudinal CE-MRI-based Siamese network with machine learning to predict tumor response in HCC after DEB-TACE.

Cancer Imaging. 2025-8-19

[4]
Application of Nanotechnology in TACE Treatment of Liver Cancer.

Int J Nanomedicine. 2025-8-4

[5]
Efficacy and safety of lenvatinib plus transarterial chemoembolization with or without programmed death-1 inhibitors in the treatment of intermediate or advanced hepatocellular carcinoma: a systematic review and meta-analysis.

Front Immunol. 2025-7-24

[6]
TACE Combined with Lenvatinib-PD-1 Versus TACE Monotherapy as Conversion Therapy Before Liver Resection in Unresectable Hepatocellular Carcinoma: A Retrospective, Propensity Score Matching Study.

J Hepatocell Carcinoma. 2025-7-22

[7]
Analysis of nosocomial infection characteristics in cancer patients after interventional therapy of 10 years: a retrospective study from 2013 to 2022.

BMC Infect Dis. 2025-7-1

[8]
Transarterial chemoembolization plus lenvatinib with or without protein-1 inhibitor for hepatocellular carcinoma with portal vein tumor thrombus.

World J Clin Oncol. 2025-6-24

[9]
Sorafenib with or without co-interventions for hepatocellular carcinoma.

Cochrane Database Syst Rev. 2025-6-26

[10]
Long-term survival in advanced unresectable HCC treated with transcatheter arterial chemoembolization combined with lenvatinib and PD-1 inhibitors.

Oncologist. 2025-6-4

本文引用的文献

[1]
Radiomics Analysis on Multiphase Contrast-Enhanced CT: A Survival Prediction Tool in Patients With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization.

Front Oncol. 2020-7-21

[2]
Evaluation of liver tumour response by imaging.

JHEP Rep. 2020-4-28

[3]
Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of tumor response in hepatocellular carcinoma after DEB-TACE.

Eur Radiol. 2020-10

[4]
Increased Arterio-Portal Shunt Formation after Drug-Eluting Beads TACE for Hepatocellular Carcinoma.

Oncology. 2020-5-18

[5]
Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma.

N Engl J Med. 2020-5-14

[6]
Predicting the Outcome of Transcatheter Arterial Embolization Therapy for Unresectable Hepatocellular Carcinoma Based on Radiomics of Preoperative Multiparameter MRI.

J Magn Reson Imaging. 2020-10

[7]
Prognostic Value of TP53 Mutation for Transcatheter Arterial Chemoembolization Failure/Refractoriness in HBV-Related Advanced Hepatocellular Carcinoma.

Cancer Res Treat. 2020-7

[8]
Switching to systemic therapy after locoregional treatment failure: Definition and best timing.

Clin Mol Hepatol. 2020-4

[9]
Radiomics of hepatocellular carcinoma.

Abdom Radiol (NY). 2021-1

[10]
Randomised, multicentre prospective trial of transarterial chemoembolisation (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma: TACTICS trial.

Gut. 2020-8

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