原发性肝癌手术联合放疗的近期研究进展

手术是原发性肝癌的主要根治性治疗手段,而术后复发率高是影响其疗效的主要因素。随着医学技术的发展,放疗对于肝癌治疗的安全性和有效性已得到广泛证实。本文从肝癌合并门静脉癌栓的术前及术后放疗、窄切缘术后的辅助放疗、微血管侵犯术后的辅助放疗、肝移植手术前的桥接放疗、局限于肝内初始不可切除肝癌的转化性降期放疗方面,探讨肝癌手术前后放疗的现状和未来前景。虽然放疗是肝癌的有效治疗手段之一,但仍需前瞻性、随机、对照的Ⅲ期研究,以获得更高级别的循证医学证据,进一步确立放疗在肝癌治疗中的地位。

Recent research progress on surgery combined with radiation therapy for primary liver cancer

Surgical resection is the main radical treatment of early and mid-stage primary liver cancer (PLC), but the high postoperative recurrence rate is the main factor affecting the curative effect. With recent advancement in techniques, the efficacy and safety of radiation therapy for PLC have been widely proven. In this review, we will investigate the combination of surgery and radiation therapy, covering the topics of preoperative or postoperative radiotherapy for PLC with portal vein tumor thrombus, postoperative adjuvant radiotherapy in PLC with narrow surgical margin or microvascular invasion, stereotactic body radiation therapy as a bridge to liver transplantation, radiotherapy in conversion to resectability for intrahepatic inoperable PLC. Despite radiation therapy is one of the effective therapeutic options for PLC, there is still a compelling need for prospective, randomized, controlled phase Ⅲ trials to acquire high-levelclinical evidence for confirming the role of radiation therapy in the treatment of PLC.