传统经动脉化疗栓塞术与载药微球经动脉化疗栓塞术:治疗不可切除肝细胞癌的更佳选择。

Conventional versus drug-eluting bead transarterial chemoembolization: A better option for treatment of unresectable hepatocellular carcinoma.

作者信息

Razi Murtuza, Jianping Gu, Xu He, Ahmed Mohammed Jameeluddin

机构信息

Department of Interventional Radiology, Nanjing Medical University Third School of Clinical Medicine, Nanjing First Hospital, Nanjing, Jiangsu, 210006, China.

出版信息

J Interv Med. 2020 Nov 10;4(1):11-14. doi: 10.1016/j.jimed.2020.10.006. eCollection 2021 Feb.

Abstract

Transarterial chemoembolization (TACE) is a minimally invasive procedure involving intra-arterial catheter-based chemotherapy to selectively administer high doses of cytotoxic drugs to the tumor bed along with ischemic necrosis induced by arterial embolization. Chemoembolization forms the essential core of management in patients with hepatocellular carcinoma (HCC) who are not suitable for curative therapies such as transplantation, resection, or percutaneous ablation. TACE of hepatic cancer(s) has proven to be helpful in achieving local tumor control, and has supported the ability to prevent tumor progression, prolong patient life, and manage patient symptoms. Recent data have demonstrated that, in patients with single-nodule HCC ≤3 ​cm without vascular invasion, the 5-year overall survival with TACE was found to be comparable with hepatic resection and radiofrequency ablation. Used for several years, Lipiodol continues to play a vital role as a tumor-seeking and radiopaque drug delivery vector in interventional oncology. Efforts have been made to enhance the administration of chemotherapeutic agents to tumors. Compared with conventional TACE, drug-eluting bead TACE is a fairly new drug delivery embolization technique that permits fixed dosing and has the ability to provide sustained release of anticancer agents over a period of time. The present review discusses the basic procedure of TACE and its properties, and the effectiveness of conventional and drug-eluting bead chemoembolization systems currently available or presently undergoing clinical evaluation.

摘要

经动脉化疗栓塞术(TACE)是一种微创手术,包括基于动脉内导管的化疗,以选择性地向肿瘤床给予高剂量细胞毒性药物,同时通过动脉栓塞诱导缺血性坏死。化疗栓塞术是不适合进行移植、切除或经皮消融等根治性治疗的肝细胞癌(HCC)患者治疗的核心组成部分。肝癌的TACE已被证明有助于实现局部肿瘤控制,并有助于预防肿瘤进展、延长患者生命和控制患者症状。最近的数据表明,在无血管侵犯的单个结节性肝癌≤3厘米的患者中,TACE的5年总生存率与肝切除和射频消融相当。多年来,碘油在介入肿瘤学中作为一种寻瘤和不透射线的药物递送载体继续发挥着至关重要的作用。人们一直在努力加强化疗药物向肿瘤的给药。与传统TACE相比,载药微球TACE是一种相当新的药物递送栓塞技术,它允许固定剂量给药,并能够在一段时间内持续释放抗癌药物。本综述讨论了TACE的基本操作及其特性,以及目前可用或正在进行临床评估的传统和载药微球化疗栓塞系统的有效性。

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