肝癌经导管灌注化疗栓塞的选择与疗效评价

经导管肝动脉化疗栓塞术（Transcatheterarterialchemoembolization，TACE）广泛应用于不可切除肝癌患者中。以往临床上最常用的栓塞剂是碘化油和明胶海绵，最近新型栓塞剂，如载药微球和Y-90放疗栓塞微球引入临床，显示了良好的肿瘤治疗效果。同时分子靶向药物出现，与化疗栓塞联合使用，这种协同治疗效果也正在研究中。TACE治疗后的疗效评价十分重要，各种影像检查手段，如超声、计算机断层显像（computedtomography，CT）、核磁共振成像（magneticresonanceimaging，MRI）、正电子发射计算机断层显像（positronemissiontomography，PET）等，在治疗反应评价中发挥了重要作用。而功能成像手段，如弥散加权成像（diffusionweightedimaging，DWI）、灌注加权成像（perfusionweightedimaging，PWI）和PET等检查手段，日益受到临床重视。

Indications and therapeutic assessment of transcatheter arterial chemoembolization for liver cancer

Transcatheter arterial chemoembolization （TACE） has been performed widely for patients with unresectable liver cancer. And lipiodol and gelatin sponge have been the most popular embolic agents. Recently, ehemoembolization with drug-eluting beads and radioembolization with yttrium-90 mierospheres have been introduced into clinical setting, showing satisfactory tumor response. Moreover, combined chemoembolization and molecular targeted agent is now used to evaluate the synergistic effect. Monitoring tumor response to TACE is very important. Imaging including ultrasonography, computed tomography （CT） , magnetic resonance imaging （MRI） and positron emission tomography （PET） plays an important role in assessing therapeutic effects. Functional imaging such as diffusion weighted imaging （DWI）, perfusion weighted imaging （PWI） and PET is also emphasized.