Department of Medical Imaging, Western University, London, ON.
Department of Radiology, University of British Columbia, Vancouver, BC.
Curr Oncol. 2020 Nov;27(Suppl 3):S144-S151. doi: 10.3747/co.27.7171. Epub 2020 Nov 1.
Locoregional therapies (lrts) play an important role in the treatment of hepatocellular carcinoma (hcc), with the aim of increasing overall survival while preserving liver function. Various forms of lrt are available, and choosing the best one depends on technical aspects, liver morphology, tumour biology, and the patient's symptoms. The purpose of the present review article is to provide an overview of the current evidence relating to the use of percutaneous ablation, transarterial chemoembolization, and transarterial radioembolization for the curative or palliative treatment of hcc. Special situations are also reviewed, including the combined use of systemic therapy and lrt, indications and techniques for bridging to transplant and downstaging, and the use of lrt to treat patients with hcc and macrovascular invasion.
局部区域治疗(lrts)在肝细胞癌(hcc)的治疗中起着重要作用,旨在提高总体生存率的同时保留肝功能。有多种形式的 lrts 可供选择,选择最佳治疗方法取决于技术方面、肝脏形态、肿瘤生物学和患者的症状。本文综述的目的是提供当前关于经皮消融、经动脉化疗栓塞和经动脉放射栓塞治疗 HCC 的疗效或姑息治疗的证据概述。还回顾了特殊情况,包括系统治疗与 lrts 的联合应用、桥接移植和降期的适应证和技术,以及 lrts 治疗合并大血管侵犯的 HCC 患者。