Allgaier H P, Deibert P, Blum H E
Abteilung Innere Medizin II (Gastroenterologie, Hepatologie und Endokrinologie), Medizinische Universitätsklinik Freiburg.
Praxis (Bern 1994). 1997 Jan 21;86(4):86-90.
Indications for a local non-surgical therapy of focal liver lesions are the hepatocellular carcinoma (HCC) and metastases. The HCC is one of the most frequent malignant tumors worldwide with an incidence of 1 million cases per year. The prognosis of the untreated HCC is poor. For non-surgical cases there are local and systemic therapies available. A number of studies involving thousands of patients, have used treatment by PEI. Several of these studies have shown an increased survival in the PEI-treated patients. For patients primarily not treatable with PEI transarterial chemoembolization (TACE) with lipiodol in combination with a chemotherapeutic drug and gelfoam is a possibility. Studies of patients treated with PEI or TACE show a variability in survival, however, the trend is to prolonged survival. Improvement in efficacy of treatment and decreases in toxicities could be achieved through a combination of different interventions and an optimal patient selection. Both surgical and those cases unsuitable to local therapy should be treated with tamoxifen.
局部非手术治疗局灶性肝病变的适应证为肝细胞癌（HCC）和转移瘤。HCC是全球最常见的恶性肿瘤之一，每年发病率达100万例。未经治疗的HCC预后较差。对于非手术病例，有局部和全身治疗方法。多项涉及数千名患者的研究采用了经皮乙醇注射（PEI）治疗。其中一些研究表明，接受PEI治疗的患者生存率有所提高。对于主要无法用PEI治疗的患者，经动脉化疗栓塞（TACE）联合碘油、化疗药物和明胶海绵是一种选择。对接受PEI或TACE治疗的患者的研究显示出生存率的差异，然而，趋势是生存期延长。通过不同干预措施的联合和最佳患者选择，可以提高治疗效果并降低毒性。手术病例和不适于局部治疗的病例均应使用他莫昔芬治疗。
