Huppert P E, Viebahn R, Duda S H, Lauchart W
Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen.
Zentralbl Chir. 1994;119(11):787-93.
Interventional treatment of hepatocellular carcinoma is indicated if surgical treatment is impossible. Selection of the individual method of interventional treatment is determined by the size, location and number of tumors and by the grade of tumor vascularization. Tumors below 5 cm in diameter are well-suitable for aethanol ablation. In larger tumors and in tumors with high-grade vascularization transarterial chemoembolization is probably more effective. In patients with more than 3 tumor nodules chemoembolization is the treatment of choice. On the other hand chemoembolization shows reduced efficacy in tumors with low-grade hypervascularization and the aethanol ablation as a stand-alone procedure or supplemental treatment seems to be valuable. Until now there is no generally accepted opinion in terms of the indications for different methods of interventional treatment. Further comparative studies including aethanol ablation, chemoembolization and resection are necessary.
如果无法进行手术治疗，则需进行肝细胞癌的介入治疗。介入治疗具体方法的选择取决于肿瘤的大小、位置、数量以及肿瘤血管化程度。直径小于5厘米的肿瘤非常适合乙醇消融。对于较大的肿瘤以及血管化程度高的肿瘤，经动脉化疗栓塞可能更有效。对于有3个以上肿瘤结节的患者，化疗栓塞是首选治疗方法。另一方面，化疗栓塞在血管化程度低的高血供肿瘤中的疗效降低，而乙醇消融作为单独治疗或辅助治疗似乎很有价值。到目前为止，对于不同介入治疗方法的适应症尚无普遍接受的观点。有必要进一步开展包括乙醇消融、化疗栓塞和切除术在内的对比研究。
