中晚期肝癌转化治疗中的几个焦点问题

我国大部分肝癌患者初诊时已处于中晚期,失去了通过手术切除获得长期生存的机会。当前系统治疗的发展、局部治疗技术的进步有望让更多中晚期不可切除肝癌患者从转化治疗中获益。经过初步探索,局部联合系统治疗的多模式、高强度的转化治疗方案展现了可喜的转化成功率。然而,关于如何选择转化治疗目标人群及转化方案、何时序贯手术切除在内的一系列问题尚存在争议。笔者回顾国内外相关研究进展,围绕转化治疗中的几个焦点问题进行探讨。

Several focus issues of conversion therapies for intermediate-advanced hepatocellular carcinoma

Most patients with hepatocellular carcinoma are diagnosed at intermediate-advanced stage in China, losing the chance of long-term survival through surgical resection. In recent years, locoregional therapy and systemic therapies of hepatocellular carcinoma have achieved great progress and more patients with intermediate-advanced unresectable hepatocellular carcinoma are expected to benefit from conversion therapies. After preliminary exploration, the multi-mode and high-intensity conversion therapies through combining locoregional therapy and system therapy has shown a gratifying success rate. However, there is still no consensus on the target population, regimen options and operation opportunity of conversion therapies. The paper reviews the domestic and foreign research progress and discusses several focus issues of conversion therapies for intermediate-advanced hepatocellular carcinoma.