介入治疗在中晚期肝癌降期中的作用

介入治疗已成为中晚期肝癌姑息治疗的主力军。与此同时,在肝癌降期领域,介入治疗也发挥着越来越重要的作用,通过局部介入治疗可使中晚期肝癌的瘤灶体积减小、数量减小使之符合肝癌移植或者切除术标准。介入降期技术包括经肝动脉化疗栓塞术、药物缓释微球、经动脉放射性栓塞治疗以及各种消融治疗技术(射频消融、微波消融、冷冻消融、酒精消融)等。最佳的介入降期策略仍未达成共识,但是通过开展高级别循证医学研究,对不同方法的最佳可获益人群进行筛选,评估不同介入降期策略对后续肝移植手术在手术难度、安全性、术后疗效等方面的影响,有望提升介入治疗在中晚期肝癌降期的效果。

Role of interventional therapy in the downstaging of advanced liver cancer

Interventional therapy has become an important palliative therapy for advanced liver cancer, and meanwhile, interventional therapy is playing an important role in the downstaging of liver cancer. Local interventional therapy can help patients meet the criteria for transplantation or resection by reducing tumor volume and number in patients with advanced liver cancer. Interventional downstaging techniques include transarterial chemotherapy, drug-eluting beads, transarterial radioembolization, and various ablation techniques (radiofrequency ablation, microwave ablation, cryoablation, and ethanol ablation). No consensus has been reached on the optimal interventional downstaging strategy, while high-level evidence-based clinical studies are needed to screen out the optimal candidates for different methods and evaluate the complexity, safety, and long-term efficacy of subsequent liver transplantation after interventional downstaging therapy, so as to improve the effect of interventional therapy in the downstaging of advanced liver cancer.