2020年至2021年中国三级医院专家对肝细胞癌临床实践的调查
A Survey of Clinical Practices for Hepatocellular Carcinoma Among Experts at Tertiary Hospitals in China From 2020 to 2021.
作者信息
Zhao Hong, Mao Yilei, Wang Hongguang, Zhou Aiping, Yang Zhengqiang, Han Yue, Li Gong, Bi Xinyu, Hao Chunyi, Wang Xiaodong, Zhou Jun, Dai Chaoliu, Wen Feng, Zhang Jingdong, Liu Ruibao, Li Tao, Zhao Lei, Niu Zuoxing, Wen Tianfu, Li Qiu, Zhang Hongmei, Chen Xiaoming, Chen Minshan, Zhao Ming, Chen Yajin, Yu Jun, Shen Jie, Li Xiangchen, Liu Lianxin, Huang Zhiyong, Zhang Wei, Shen Feng, Zhou Weiping, Yuan Zhengang, Zhai Jian, Ge Ningling, Chen Yongjun, Sun Huichuan, Cai Jianqiang
机构信息
Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital PUMC and Chinese Academy of Medical Sciences (CAMS) Beijing China.
出版信息
Cancer Innov. 2025 Apr 7;4(3):e70006. doi: 10.1002/cai2.70006. eCollection 2025 Jun.
BACKGROUND
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death in China. The rapid progress in systemic therapies has led to the approval of many therapeutic methods that have quickly changed clinical guidelines and practices. Because of the high heterogeneity of HCC, there are still some gaps between the guidelines and real-world clinical practice. The present study surveyed experts in China to investigate the current treatment concepts and clinical practice regarding HCC.
METHODS
A questionnaire survey on the treatment concepts and clinical practice of HCC was administered to 310 experts with senior professional titles in 2020 and 312 experts in 2021. The results were analyzed and compared.
RESULTS
For treating patients with resectable HCC, 28% of hepatobiliary surgeons indicated neoadjuvant therapy, and 7% chose systemic therapy ± locoregional therapy as 1 L therapy in 2021 compared with 20% and 1% in 2020. More experts chose adjuvant treatment within 1 month in 2021 compared with 2020, and 6 months and 12 months were the leading choices for the duration of adjuvant treatment. In 2021, 79% of surgeons and 19% of interventionalists were willing to conduct downstaging/conversion therapy for patients with potentially resectable HCC, and 78% chose tyrosine kinase inhibitors (TKI) + immunotherapy (IO) + locoregional therapy for cases in which R0 resection could not be achieved. For completely unresectable HCC, more experts preferred TKI + IO-based therapy as 1 L therapy in 2021 compared with 2020 (78% vs. 55%). The proportion of experts who indicated TKI + IO-based therapy as 2 L therapy increased from 32% in 2020 to 40% in 2021.
CONCLUSION
The survey results indicated that in 2021, compared with 2020, more experts opted to administer IO + TKI for the treatment of liver cancer, and more experts and patients were willing to participate in clinical research.
背景
肝细胞癌（HCC）是中国癌症相关死亡的第二大主要原因。全身治疗的快速进展使得许多治疗方法获得批准，这些方法迅速改变了临床指南和实践。由于HCC的高度异质性，指南与实际临床实践之间仍存在一些差距。本研究对中国专家进行了调查，以探究目前关于HCC的治疗理念和临床实践。
方法
2020年对310名具有高级专业职称的专家以及2021年对312名专家进行了关于HCC治疗理念和临床实践的问卷调查。对结果进行了分析和比较。
结果
对于可切除HCC患者的治疗，2021年28%的肝胆外科医生表示采用新辅助治疗，7%选择全身治疗±局部区域治疗作为一线治疗，而2020年分别为20%和1%。与2020年相比，2021年更多专家选择在1个月内进行辅助治疗，辅助治疗持续时间的主要选择是6个月和12个月。2021年，79%的外科医生和19%的介入科医生愿意对潜在可切除HCC患者进行降期/转化治疗，78%的医生对于无法实现R0切除的病例选择酪氨酸激酶抑制剂（TKI）+免疫治疗（IO）+局部区域治疗。对于完全不可切除的HCC，与2020年相比，2021年更多专家倾向于采用以TKI+IO为基础的治疗作为一线治疗（78%对55%）。表示以TKI+IO为基础的治疗作为二线治疗的专家比例从2020年的32%增至2021年的40%。
结论
调查结果表明，2021年与2020年相比，更多专家选择采用IO+TKI治疗肝癌，更多专家和患者愿意参与临床研究。
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