肝癌多学科综合治疗的分级与集合治疗模式的建立

目的 提出肝癌治疗分类和分级的新概念,建立肝癌治疗新模式.方法 根据肝癌既是局部病变,又是全身性疾病的特点,提出肝癌治疗新理念.依据肝癌治疗方法 的治疗目标和机理,提出不同于传统的按学科分类的肝癌治疗分级方法 .根据肝癌各级治疗目标与治疗方法 之间的关系,建立肝癌治疗新模式.结果 提出了全方位、系统化、规范化、个体化、动态式、经济型的肝癌治疗设计的新理念.肝癌的治疗目标包括局部肿瘤病灶、肝内的转移、全身性播散、慢性肝病、全身内环境和肿瘤康复等六个方面,肝癌的治疗方法 则相应地分为六级(G_1～G_6).建立了以各种治疗目标选择治疗方法 的肝癌集合治疗模式(ATM),其数学概念是ATME∈{G_1,G_2,…,Gn),并建立了相应的能够评价ATM应用进程的数学模型.结论 建立的肝癌ATM及其数学模型揭示了各项治疗之间的内在关系.可用于肿瘤治疗方案的策划并有助于随时调整治疗方案.

Classification of multidisciplinary synthetic therapy and creation of aggregate treatment mode for hepatocellular carcinoma

Objective To introduce a new concept of classification and gradation of cancer therapy for hepatocellular carcinoma(HCC)and establish a novel treatment mode.Methods The new therapeutic concepts were proposed based on current knowledge about partial and general features of tumors.A new concept of classification and gradation of HCC therapy was introduced based on the different primary aims and mechanisms of treatment as opposed to previous traditional classifications.A novel treatment mode for HCC therapy was established according to the relationship between the objective and method of treatment.Results Six basic principles for planning HCC therapy were proposed,which were all-around and systematic,standardized and individualized,dynamic and economic.The objective of HCC therapy included six aspects such as the tumor focus,latent cancer cells in the liver,metastases and free cancer cells theoretically exist in blood,chronic liver disease,homeostasis and oncology rehabilitation etc.The total treatment was subdivided into 6 grades(G_1～G_6)accordingly.An aggregate treatment mode(ATM)for HCC was created,which is a multidisciplinary synthetic combination therapy that assembles various therapeutic methods at different objective levels; namely ATM∈{G_1,G_2,…,G_n}.A mathematical model was built to evaluate the process of implementation of ATM.Conclusion The ATM and the mathematical model can be used to explore the internal relationship between diverse treatments.It is helpful not only to design a regimen to guide cancer therapy but also to assistant to timely adjust the therapeutic regimen.