中国实用外科杂志

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肝癌多学科诊疗体系的建立及其评价

王    伟,刘连新   

  1. 中国科学技术大学附属第一医院(安徽省立医院)肝胆外科 肝胆胰外科安徽省重点实验室 安徽省肝胆疾病临床医学研究中心,安徽合肥230001  
  • 出版日期:2024-09-01

  • Online:2024-09-01

摘要: 近年来,肝癌的治疗方法取得了显著进展,包括手术、介入治疗、放射治疗和系统治疗,特别是靶向药物和免疫检查点抑制剂的出现,为晚期肝癌病人的转化切除提供了更多可能。然而,单一治疗模式的局限性凸显,建立多学科综合治疗协作组(MDT)成为优化治疗效果的重要手段。MDT团队由多学科专家组成,能够根据病人个体化需求制定最佳治疗方案,并通过综合评估病情,协调各科室间的协作,确保治疗的全面性和高效性。MDT体系不仅在提高病人的总生存率和根治性治疗机会方面表现出色,还在缩短治疗等待时间、提高治疗接受率及病人满意度方面发挥了积极作用。MDT体系的构建为肝癌病人提供了以病人为中心的全方位支持,有助于改善病人的预后和生活质量,然而,其实施过程中的资源整合、团队沟通及病人依从性等问题仍需克服。

关键词: 肝癌, 恶性消化道肿瘤, 多学科综合治疗协作组, 靶向治疗, 免疫检查点抑制剂, 根治性切除, 肝癌规范诊疗, 远程会诊

Abstract: In recent years, significant advancements have been made in the treatment of liver cancer, including surgery, interventional therapy, radiation therapy, and systemic therapy. The emergence of targeted therapies and immune checkpoint inhibitors, in particular, has provided new possibilities for conversion therapy in patients with advanced liver cancer. However, the limitations of single-treatment modalities have become evident, underscoring the importance of establishing multidisciplinary treatment (MDT) teams to optimize therapeutic outcomes. MDT teams, composed of experts from various specialties, are capable of formulating the best treatment plans based on individual patient needs, ensuring comprehensive and efficient care through coordinated efforts across departments. The MDT system has demonstrated its effectiveness not only in improving overall survival rates and opportunities for curative treatment but also in reducing treatment delays, increasing treatment acceptance rates, and enhancing patient satisfaction. The construction of the MDT system offers patient-centered, holistic support for liver cancer patients, contributing to improved prognosis and quality of life. Nevertheless, challenges remain in the implementation of the MDT system, including resource integration, team communication, and patient adherence.

Key words: liver cancer, malignant digestive tract tumor, multidisciplinary team, targeted therapy, immune checkpoint inhibitors, radical resection, standardized treatment of liver cancer, teleconsultation