精准医疗时代背景下的肝动脉灌注化疗

肝细胞癌（HCC）是全球最常见的肝脏恶性肿瘤，肝切除、肝移植以及消融是早期HCC根治性的治疗方式。目前，我国大多数HCC患者确诊时已经处于疾病晚期，临床实践中以系统治疗为主。索拉非尼（sorafenib）和仑伐替尼（lenvatinib）作为国际公认的晚期HCC一线治疗方案。在亚洲地区，肝动脉灌注化疗（HAIC）也作为临床上晚期HCC的一线治疗；HAIC直接将抗肿瘤药物经导管注入至肝肿瘤供血血管，以获得较高的反应率和较明显的生存优势，降低了化疗药的全身毒副作用；然而，由于缺乏以全球人群作为研究对象的随机对照试验，HAIC尚无法在国际上广泛应用。本文中，我们将系统阐述目前HAIC应用于治疗晚期HCC的研究现状及临床适用人群，认为HAIC可作为晚期HCC的标准治疗方案之一，未来联合小分子酪氨酸激酶抑制剂（TKI）及/或免疫治疗进一步提高晚期HCC患者的生存。

Hepatic Arterial Infusion Chemotherapy in the Era of Precise Medicine

Hepatocellular carcinoma（HCC）is the most common malignant liver tumor in the world. Hepatectomy ，liver transplantation and ablation may be the potential radical treatments for early liver cancer patients. At present ，most of the patients with HCC in China are in the late stage of the disease，mainly requiring systematic treatment. Sorafenib and Lenvatinib are internationally recognized as first-line therapy for advanced HCC. In Asia ，hepatic arterial infusion chemotherapy（HAIC）is used as a first-line regimen for the treatment of advanced HCC. In HAIC，antineoplastic drugs are directly injected into the blood supply vessels of liver tumors，obtaining high reaction rate and obvious survival advantages，and reducing the systemic toxicity and side effects of chemotherapy drugs. However，HAIC is not yet widely used worldwide due to the lack of accurate evidence from randomized controlled clinical trials（RCT）targeting global populations. In this paper，we will systematically review the current research status of HAIC and its dominant population. Moreover，we speculate that HAIC will be the standard therapy for advanced HCC or combined with tyrosine kinase inhibitor （TKI）and / or immunotherapy to prolong these patients′ life in the near future.