肝癌的局部区域治疗

局部区域治疗在影像学引导下靶向杀伤肿瘤，是原发性肝癌最主要的非手术治疗方法，包括放射介入治疗（主要为肝动脉化疗栓塞）和局部消融治疗（瘤内乙醇注射、射频、微波、激光、高强度聚焦超声、冷冻等治疗）。肝动脉化疗栓塞主要应用于不能手术切除的中晚期肝癌，局部消融治疗适用于直径5cm以下的小肝癌。肝癌局部区域治疗强调针对具体病情选择合适的方法进行规范治疗。本文简要评述各种局部区域治疗方法的指征、治疗原则、技术要点和疗效，并讨论手术切除与局部消融治疗小肝癌的选择。

Loco-regional therapy for liver cancer

Loco - regional therapy, which uses imaging technologies to facilitate targeted delivery of therapeutic agents to cancers, has emerged as the most commonly used non - surgical treatment for primary liver cancer. Since the theory of loco - regional therapy was introduced, various strategies have been developed and successfully applied in clinic, including interventional radiology methods （mainly transarterial chemoembolization） and local ablative methods （such as intraturnoral ethanol injection, radiofrequency ablation, microwave coagulation, laser -induced thermal therapy, high -intensity focused ultrasound, and cryotherapy）. TACE has been widely applied to treat inoperable liver cancers at intermediate and advanced stages, while the local ablative therapies have proven more suitable for small （ 〈 5 era） liver cancers. However, choosing the appropriate loco -regional therapy strategy should be carried out on an individual basis, considering the patient＇s particular disease condition and characteristics. To help guide such treatment decisions, this review highlights the principal indications, theory, techniques, and reported efficacies of the various loco - regional therapy strategies.