Bajestani Nojan, Wu Gavin, Hussein Ahmed, Makary Mina S
College of Medicine, The Ohio State University, Columbus, OH 43210, USA.
Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W 12th Avenue, Columbus, OH 43210, USA.
Biomedicines. 2024 Jun 27;12(7):1432. doi: 10.3390/biomedicines12071432.
More than 800,000 people worldwide are diagnosed with HCC (hepatocellular carcinoma) each year, with approximately 700,000 deaths alone occurring in that same year. Treatment of HCC presents complex therapeutic challenges, particularly in intermediate and advanced stages. LRTs such as transarterial chemoembolization (TACE) and ablations have been the mainstay treatment for early to intermediate-stage HCC, and systemic therapies are used to treat intermediate-late-stage HCC. However, novel literature describing combining LRT with systemic therapies has shown promising results. This review explores recent advances in both liver-directed techniques for hepatocellular carcinoma, including bland transarterial embolization, chemoembolization, radioembolization, and ablative therapies in conjunction as well as with systemic therapies, with a focus on combination therapies, patient selection, procedural technique, periprocedural management, and outcomes. Our findings suggest that LRT combined with systemic therapies is a viable strategy for improving progression-free survival and time to progression for patients with intermediate-to-late-stage HCC. However, further investigation is required to refine treatment protocols and define patient cohorts that would benefit the most.
全球每年有超过80万人被诊断为肝细胞癌（HCC），仅同年就有大约70万人死亡。HCC的治疗面临复杂的治疗挑战，尤其是在中晚期。诸如经动脉化疗栓塞术（TACE）和消融术等局部区域治疗（LRT）一直是早期至中期HCC的主要治疗方法，而全身治疗则用于治疗中晚期HCC。然而，描述LRT与全身治疗联合应用的新文献已显示出有前景的结果。本综述探讨了肝细胞癌肝脏定向技术的最新进展，包括单纯经动脉栓塞、化疗栓塞、放射性栓塞以及消融治疗，以及与全身治疗联合应用，重点关注联合治疗、患者选择、操作技术、围手术期管理和治疗结果。我们的研究结果表明，LRT与全身治疗联合应用是改善中晚期HCC患者无进展生存期和疾病进展时间的可行策略。然而，需要进一步研究以完善治疗方案并确定最能从中受益的患者群体。
