Zhao Ya'ning, Bai Jun, Wang Xi, Zhang Yaoren, Yan Xiaohong, Qi Jun'an, Xia Xueyan, Feng Yuansong, Duan Baojun
Department of Medical Oncology of Baoji Central Hospital, Baoji 721008, Shaanxi Province, China.
Department of Medical Oncology of Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China.
J Cancer. 2024 Feb 25;15(8):2193-2205. doi: 10.7150/jca.93885. eCollection 2024.
With the development of guidance technology and ablation equipment, ablative procedures have emerged as important loco-regional alternatives to surgical resection for recurrent hepatocellular carcinoma (rHCC) patients. Currently, ablation modalities used in clinical practice mainly include radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA), cryoablation (CRA), high-intensity focused ultrasound (HIFU), and irreversible electroporation (IRE). Accumulated comparative data of ablation versus surgical resection reveal noninferior responses and outcomes but superior adverse effects. Moreover, studies demonstrate that ablation may serve as an excellent procedure for rHCC given its exact minimal invasiveness and immune modulation. We focus on the current status of ablation in clinical practice for rHCC and discuss new research in the field, including ablation combined with these other modalities, such as targeted therapy and immunotherapy.
随着引导技术和消融设备的发展,对于复发性肝细胞癌(rHCC)患者,消融手术已成为手术切除重要的局部替代方案。目前,临床实践中使用的消融方式主要包括射频消融(RFA)、微波消融(MWA)、激光消融(LA)、冷冻消融(CRA)、高强度聚焦超声(HIFU)和不可逆电穿孔(IRE)。消融与手术切除的累积对比数据显示,两者在反应和结果上无劣效性,但消融的不良反应较少。此外,研究表明,鉴于消融具有确切的微创性和免疫调节作用,它可能是治疗rHCC的一种理想方法。我们关注rHCC临床实践中消融的现状,并讨论该领域的新研究,包括消融与其他疗法(如靶向治疗和免疫治疗)联合应用。