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肝细胞癌的治疗选择范围

Spectrum of therapeutic options in hepatocellular carcinoma.

作者信息

Shin Hyun Phil, Lee Moonhyung, Jeon Jung Won

机构信息

Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.

Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.

出版信息

J Exerc Rehabil. 2025 Aug 31;21(4):190-199. doi: 10.12965/jer.2550482.241. eCollection 2025 Aug.

Abstract

Hepatocellular carcinoma (HCC) is a prevalent cancer with high mortality rates globally. This review explores various HCC treatments, including surgical resection, liver transplantation, local ablation, and systemic therapies. With advancements in surgical techniques, local therapies, and immunotherapy, the treatment paradigm for HCC is rapidly evolving. Surgical resection remains the preferred first-line treatment for localized HCC with preserved liver function, offering significant survival benefits. Liver transplantation is suitable for patients meeting specific criteria and helps restore liver function in individuals with compromised liver capabilities, providing excellent long-term outcomes. Local ablation is recommended for very early-stage HCC ineligible for surgery, offering outcomes comparable to resection. Transarterial therapies, such as transarterial radioembolization, are employed to treat intermediate-stage HCC, enhancing treatment outcomes. Radiation therapy is increasingly utilized due to improved safety profiles, providing effective treatment options for HCC patients. Systemic treatments have advanced with the introduction of molecularly targeted therapies and immune checkpoint inhibitors, improving survival rates. The development of immunotherapy combinations has shown promising efficacy as first-line treatments. The ongoing advancement in treatment strategies, alongside personalized patient approaches, is expected to further enhance outcomes for HCC patients.

摘要

肝细胞癌(HCC)是一种在全球范围内普遍存在且死亡率很高的癌症。本综述探讨了各种肝癌治疗方法,包括手术切除、肝移植、局部消融和全身治疗。随着手术技术、局部治疗和免疫治疗的进步,肝癌的治疗模式正在迅速演变。手术切除仍然是肝功能良好的局限性肝癌的首选一线治疗方法,可带来显著的生存益处。肝移植适用于符合特定标准的患者,并有助于恢复肝功能受损患者的肝功能,提供良好的长期疗效。局部消融推荐用于不适合手术的极早期肝癌,其疗效与切除相当。经动脉治疗,如经动脉放射性栓塞,用于治疗中期肝癌,可提高治疗效果。由于安全性的改善,放射治疗越来越多地被采用,为肝癌患者提供了有效的治疗选择。随着分子靶向治疗和免疫检查点抑制剂的引入,全身治疗取得了进展,提高了生存率。免疫治疗联合方案的发展已显示出作为一线治疗的良好疗效。治疗策略的不断进步,以及个性化的患者治疗方法,有望进一步提高肝癌患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/12409303/23934eaa72a6/jer-21-4-190f1.jpg

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