切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2025, Vol. 14 ›› Issue (01) : 41 -45. doi: 10.3877/cma.j.issn.2095-3232.20250003

专家论坛

不可切除肝细胞癌的转化治疗
黄忠晶1, 张丽东1, 伍子奕1, 艾军华1,()   
  1. 1.330006 南昌大学第一附属医院普通外科
  • 收稿日期:2024-11-14 出版日期:2025-02-10
  • 通信作者: 艾军华

Transformational therapy for unresectable hepatocellular carcinoma

Zhongjing Huang1, Lidong Zhang1, Ziyi Wu1, Junhua Ai1,()   

  1. 1.Department of General Surgery, the First Affiliated Hospital of Nanchang University,Nanchang 330006, China
  • Received:2024-11-14 Published:2025-02-10
  • Corresponding author: Junhua Ai
引用本文:

黄忠晶, 张丽东, 伍子奕, 艾军华. 不可切除肝细胞癌的转化治疗[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 41-45.

Zhongjing Huang, Lidong Zhang, Ziyi Wu, Junhua Ai. Transformational therapy for unresectable hepatocellular carcinoma[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(01): 41-45.

肝细胞癌(HCC)是中国常见的恶性肿瘤之一,由于发病隐匿,一经发现大多数属于中晚期,手术切除率较低,而传统的非手术治疗效果较低。近些年来由于靶向治疗和免疫治疗的快速发展,HCC 的转化治疗日益受到重视。HCC 转化治疗是指通过局部/系统治疗将不可切除HCC 转为可切除HCC,并从手术切除获益。本文就HCC 转化治疗研究进展做一阐述。

Hepatocellular carcinoma (HCC) is one of the common malignant tumors in China.Due to hidden early onset, most HCC patients are classified in the middle and late stages upon diagnosis.Surgical resection rate is relatively low, and conventional non-surgical treatment yields poor clinical efficacy.In recent years, with rapid development of targeted therapy and immunotherapy, transformational therapy of HCC has captivated widespread attention.Transformational therapy of HCC refers to transforming unresectable HCC into resectable HCC through local/systemic therapy and benefiting from surgical resection.In this article,research progress in transformational therapy of HCC was reviewed.

[1]
Sung H, Ferlay J, Siegel R L, et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin, 2021, 71(3):209-249.
[2]
Xie DY, Zhu K, Ren ZG, et al.A review of 2022 Chinese clinical guidelines on the management of hepatocellular carcinoma: updates and insights[J].Hepatobiliary Surg Nutr, 2023, 12(2):216-228.
[3]
中华人民共和国国家卫生健康委员会医政司.原发性肝癌诊疗指南 (2024年版)[J/OL].中华肝脏外科手术学电子杂志, 2024,13(4):407-449.
[4]
He MK, Liang RB, Zhao Y, et al.Lenvatinib, toripalimab, plus hepatic arterial infusion chemotherapy versus lenvatinib alone for advanced hepatocellular carcinoma[J].Ther Adv Med Oncol, 2021,13:17588359211002720.
[5]
Zeng H, Chen W, Zheng R, et al.Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries[J].Lancet Glob Health, 2018, 6(5): e555-e567.
[6]
Bai J, Huang M, Song B, et al.The current status and future prospects for conversion therapy in the treatment of hepatocellular carcinoma[J].Technol Cancer Res Treat, 2023, 22:15330338231159718.
[7]
Laface C, Fedele P, Maselli FM, et al.Targeted therapy for hepatocellular carcinoma: old and new opportunities[J].Cancers,2022, 14(16):4028.
[8]
Ouyang T, Kan X, Zheng C.Immune checkpoint inhibitors for advanced hepatocellular carcinoma: monotherapies and combined therapies[J].Front Oncol, 2022, 12:898964.
[9]
Qin S, Bi F, Gu S, et al.Donafenib versus sorafenib in first-line treatment of unresectable or metastatic hepatocellular carcinoma: a randomized, open-label, parallel-controlled phase Ⅱ-Ⅲ trial[J].J Clin Oncol, 2021, 39(27):3002-3011.
[10]
Hu L, Zheng Y, Lin J, et al.Comparison of the effects of lenvatinib and sorafenib on survival in patients with advanced hepatocellular carcinoma: a systematic review and meta-analysis[J].Clin Res Hepatol Gastroenterol, 2023, 47(1):102061.
[11]
Finn RS, Qin S, Ikeda M, et al.Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma[J].N Engl J Med, 2020,382(20):1894-1905.
[12]
Kudo M.Scientific rationale for combined immunotherapy with PD-1/PD-L1 antibodies and VEGF inhibitors in advanced hepatocellular carcinoma[J].Cancers, 2020, 12(5):1089.
[13]
Finn RS, Ikeda M, Zhu AX, et al.Phase Ⅰb study of lenvatinib plus pembrolizumab in patients with unresectable hepatocellular carcinoma[J].J Clin Oncol, 2020, 38(26):2960-2970.
[14]
闫向勇, 李俊, 牛小娟, 等.PD-1抑制剂联合靶向药物治疗晚期原发性肝癌的安全性及临床疗效观察[J].现代肿瘤医学, 2023,31(5):875-880.
[15]
Qin S, Cheng Y, Liang J, et al.Efficacy and safety of the FOLFOX4 regimen versus doxorubicin in Chinese patients with advanced hepatocellular carcinoma: a subgroup analysis of the EACH study[J].Oncologist, 2014, 19(11):1169-1178.
[16]
林志宇, 马闻, 付榆, 等.三氧化二砷治疗中晚期原发性肝癌的近期疗效[J].中国医药指南, 2014, 12(30):28-28, 29.
[17]
况圣佳.经导管肝动脉化疗栓塞治疗对晚期肝癌患者肿瘤坏死体积及并发症的影响 [J].中国医学创新, 2022, 19(5):10-13.
[18]
Kloeckner R, Weinmann A, Prinz F, et al.Conventional transarterial chemoembolization versus drug-eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma[J].BMC Cancer, 2015, 15:465.
[19]
中国抗癌协会肿瘤介入学专业委员会, 中国抗癌协会肿瘤介入学专业委员会化疗与免疫治疗分委会.改良式经皮肝动脉化疗药盒植入技术中国专家共识(2022版)[J].临床肝胆病杂志, 2022, 38(11):2462-2469.
[20]
Li QJ, He MK, Chen HW, et al.Hepatic arterial infusion of oxaliplatin,fluorouracil, and leucovorin versus transarterial chemoembolization for large hepatocellular carcinoma: a randomized phase Ⅲ trial[J].J Clin Oncol, 2022, 40(2):150-160.
[21]
Li S, Lyu N, Han X, et al.Hepatic artery infusion chemotherapy using fluorouracil, leucovorin, and oxaliplatin versus transarterial chemoembolization as initial treatment for locally advanced hepatocellular carcinoma: a propensity score-matching analysis[J].J Vasc Interv Radiol, 2021, 32(9):1267-1276, e1.
[22]
Wei X, Jiang Y, Zhang X, et al.Neoadjuvant three-dimensional conformal radiotherapy for resectable hepatocellular carcinoma with portal vein tumor thrombus: a randomized, open-label, multicenter controlled study[J].J Clin Oncol, 2019, 37(24):2141-2151.
[23]
Ferini G, Palmisciano P, Scalia G, et al.The role of radiation therapy in the treatment of spine metastases from hepatocellular carcinoma:a systematic review and meta-analysis[J].Neurosurg Focus, 2022,53(5): E12.
[24]
曹磊, 廖明恒, 曾勇.肝叶增生促进技术在剩余肝体积不足肝切除中的应用 [J/OL].中华肝脏外科手术学电子杂志, 2021, 10(6):539-543.
[25]
Aoki T, Kubota K.Preoperative portal vein embolization for hepatocellular carcinoma: consensus and controversy[J].World J Hepatol, 2016, 8(9):439-445.
[26]
Huang Y, Ge W, Kong Y, et al.Preoperative portal vein embolization for liver resection: an updated meta-analysis[J].J Cancer, 2021, 12(6):1770-1778.
[27]
Wajswol E, Jazmati T, Contractor S, et al.Portal vein embolization utilizing N-butyl cyanoacrylate for contralateral lobe hypertrophy prior to liver resection: a systematic review and meta-analysis[J].Cardiovasc Intervent Radiol, 2018, 41(9):1302-1312.
[28]
陈一帆, 黄博, 卢杏生.联合肝脏离断和门静脉结扎二步肝切除术的应用进展[J].南京医科大学学报(自然科学版), 2022, 42(6):891-896.
[29]
Wang Z, Peng Y, Hu J, et al.Associating liver partition and portal vein ligation for staged hepatectomy for unresectable hepatitis B virus-related hepatocellular carcinoma: a single center study of 45 patients[J].Ann Surg, 2020, 271(3):534-541.
[30]
刘腾, 常秀娟, 何权威, 等.冷冻消融协同仑伐替尼和程序性死亡受体1单抗治疗不可切除肝细胞癌的效果及安全性分析[J].临床肝胆病杂志, 2024, 40(3):539-549.
[31]
Zhu HD, Li HL, Huang MS, et al.Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001)[J].Signal Transduct Target Ther, 2023,8(1):58.
[32]
曹耿飞, 张海潇, 顾俊鹏, 等.载药微球栓塞联合索拉非尼治疗不可切除肝癌安全性和疗效[J/OL].中华肝脏外科手术学电子杂志,2021, 10(1):43-47.
[33]
Lin LW, Ke K, Yan LY, et al.Efficacy and safety of hepatic artery infusion chemotherapy combined with tyrosine kinase inhibitors plus programmed death-1 inhibitors for hepatocellular carcinoma refractory to transarterial chemoembolization[J].Front Oncol, 2023, 13:1178428.
[34]
Chiang CL, Chiu KWH, Chan KSK, et al.Sequential transarterial chemoembolisation and stereotactic body radiotherapy followed by immunotherapy as conversion therapy for patients with locally advanced, unresectable hepatocellular carcinoma (START-FIT): a single-arm, phase 2 trial[J].Lancet Gastroenterol Hepatol, 2023,8(2):169-178.
[1] 刘琴, 刘瀚旻, 谢亮. 基质金属蛋白酶在儿童哮喘发生机制中作用的研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 564-568.
[2] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[3] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[4] 林逸, 钟文龙, 李锴文, 何旺, 林天歆. 广东省医学会泌尿外科疑难病例多学科会诊(第15期)——转移性膀胱癌的综合治疗[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 648-652.
[5] 吴伟宙, 王琼仁, 詹雄宇, 郑明星, 李亚县. 广东省医学会泌尿外科疑难病例多学科会诊(第16期)——左肾肉瘤样癌[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 525-529.
[6] 李勇, 彭天明, 王倩倩, 陈育纯, 蒲小勇, 刘久敏. 基于失巢凋亡相关基因的膀胱癌预后模型构建及分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 331-339.
[7] 李飞, 郑灶松, 吴芃, 谭万龙. 广东省医学会泌尿外科疑难病例多学科会诊(第16期)——延胡索酸水合酶缺陷型晚期肾细胞癌[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 410-414.
[8] 张青, 宋明, 闫嘉, 王娇. 卡瑞利珠单抗联合克唑替尼治疗ALK 阳性NSCLC 疗效分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(06): 967-970.
[9] 陈用来, 谌莉, 李勇, 傅仕艳, 冉永红, 赵雅贞, 郝玉徽. 放射性肺纤维化的研究近展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(06): 1042-1047.
[10] 陈伟杰, 何小东. 胆囊癌免疫靶向治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 763-768.
[11] 魏妙艳, 徐近. 合并远处转移胰腺癌系统性治疗的梳理和展望[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 644-650.
[12] 邓小巍, 邵成浩. 胰腺神经内分泌肿瘤转化治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 456-460.
[13] 李永政, 孟煜凡, 樊知遥, 展翰翔. 胰腺神经内分泌肿瘤新辅助治疗研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 481-486.
[14] 王昌前, 林婷婷, 宁雨露, 王颖杰, 谭文勇. 光免疫治疗在肿瘤领域的临床应用新进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 575-583.
[15] 王光伟, 李桂莲, 王勇. 散发性静脉畸形的靶向治疗进展[J/OL]. 中华介入放射学电子杂志, 2024, 12(04): 380-385.
阅读次数
全文


摘要