中国实用外科杂志

中国实用外科杂志

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原发性肝癌转化治疗及其维持治疗策略

宋天强，刘雅月   

  1. 天津医科大学肿瘤医院肝胆肿瘤科 肝癌防治研究中心 国家肿瘤临床医学研究中心  天津市“肿瘤防治”重点实验室 天津市恶性肿瘤临床医学研究中心，天津300060
  • 出版日期:2021-03-01 发布日期:2021-03-18

  • Online:2021-03-01 Published:2021-03-18

摘要： 肝癌首选治疗方法为手术治疗，也是惟一能使病人获得长期生存甚至治愈的方法。但我国绝大多数肝癌病人在确诊时已处于中晚期，失去了手术机会。转化治疗是将不可切除的晚期肝癌或者潜在可切除转化为可根治性切除，故成为晚期肝癌治疗研究的热点。转化治疗的常用方法如下：（1）局部治疗，如肝动脉栓塞化疗（TACE）、经肝动脉放疗栓塞（TARE）、肝动脉灌注化疗（HAIC）。（2）系统性治疗，如靶向联合免疫治疗。（3）联合治疗，如介入治疗联合体外放射治疗、TACE联合靶向药物、HAIC联合靶向药物、HAIC联合靶向及免疫治疗。根据转化治疗的结局决定转化治疗之后的维持治疗方案，使病人获得最佳生存获益。

关键词: 肝细胞癌, 转化治疗, 维持治疗

Abstract: Conversion therapy and maintenance therapy for primary liver cancer        SONG Tian-qiang, LIU Ya-yue.Liver Cancer Center, Tianjin Medical University Cancer Institute & Hospital；National Clinical Research Center for Cancer；Tianjin Key Laboratory of Cancer Prevention and Therapy；Tianjin Clinical Research Center for Cancer, Tianjin 300060，China
Corresponding author：SONG Tian-qiang，E-mail:tjchi@
hotmail.com
Abstract    The preferred treatment for hepatocellular carcinoma（HCC）is surgery，which is the only way to achieve long-term survival and even a cure. However，the vast majority of liver cancer patients in China are already in the middle and advanced stage of diagnosis and have lost the opportunity of operation. Conversion therapy is to transform unresectable advanced liver cancer or potentially resectable liver cancer into resectable cases，so it has become a hot spot in the treatment of advanced liver cancer. Common methods of conversion therapy are as follows：1.Local treatment：TACE，TARE，HAIC；2.Systemic treatment：targeted therapy combined with immunotherapy；3.Therapeutic alliance：TACE combined with radiation therapy，TACE combined with targeted therapy，HAIC combined with targeted therapy，HAIC combined with targeted therapy and immunotherapy. According to the outcome of conversion therapy，the maintenance treatment plan after conversion therapy is determined，so that patients can obtain the best survival benefit.

Key words: hepatocellular carcinoma, conversion therapy, maintenance therapy