Lai Hsiang-Chun, Lin Hung-Jen, Jeng Long-Bin, Huang Sheng-Teng
Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40447, Taiwan.
Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan.
World J Gastrointest Oncol. 2023 Jan 15;15(1):19-35. doi: 10.4251/wjgo.v15.i1.19.
Hepatocellular carcinoma (HCC) is the fifth most common type of cancer and the fourth leading cause of cancer-related deaths in the world. HCC has a reported recurrence rate of 70%-80% after 5 years of follow-up. Controlling tumor recurrence is the most critical factor associated with HCC mortality. Conventional salvage therapies for recurrent HCC include re-hepatectomy or liver transplantation, transcatheter arterial chemoembolization, Y-90, target therapy, and immunotherapy; however, these conventional treatment modalities have yet to achieve consistently favorable outcomes. Meanwhile, previous studies have demonstrated that conventional therapies in combination with traditional Chinese medicine (TCM), acupuncture, moxibustion or dietary supplements could notably benefit patients with HCC recurrence by strengthening and augmenting the overall management strategy. However, systemic reviews related to the interactions between complementary therapies and conventional therapy in recurrent HCC are limited. In this review, we discuss the molecular mechanisms underlying the functions of complementary therapies for recurrent HCC, which include augmenting the local control to improve the congestion status of primary tumors and reducing multicentric tumor occurrence inducing autophagy, apoptosis or cell cycle arrest. TCM and its derivatives may play important roles in helping to control HCC recurrence by inhibiting epithelial-mesenchymal transition, migration, invasion, and metastasis, inhibiting cancer stem cells, and ameliorating drug resistance.
肝细胞癌(HCC)是全球第五大常见癌症类型,也是癌症相关死亡的第四大主要原因。据报道,HCC在随访5年后的复发率为70%-80%。控制肿瘤复发是与HCC死亡率相关的最关键因素。复发性HCC的传统挽救性治疗包括再次肝切除术或肝移植、经动脉化疗栓塞、钇-90、靶向治疗和免疫治疗;然而,这些传统治疗方式尚未 consistently favorable outcomes。同时,先前的研究表明,传统疗法与中药(TCM)、针灸、艾灸或膳食补充剂相结合,可以通过加强和扩大整体管理策略,显著使HCC复发患者受益。然而,关于复发性HCC中补充疗法与传统疗法之间相互作用的系统评价有限。在本综述中,我们讨论了复发性HCC补充疗法作用的分子机制,包括增强局部控制以改善原发性肿瘤的充血状态和减少多中心肿瘤的发生,诱导自噬、凋亡或细胞周期停滞。中药及其衍生物可能通过抑制上皮-间质转化、迁移、侵袭和转移、抑制癌症干细胞以及改善耐药性,在帮助控制HCC复发方面发挥重要作用。
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