在治疗肝细胞癌后使用基于疾病状况的转换概念
Shohei Komatsu1, Toshifumi Tada2, Kazuki Terashima3
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
World journal of surgery
|August 20, 2025
概括
阿提佐利祖马布加贝瓦齐祖马布 (Ate/ Bev) 改善了肝细胞癌 (HCC) 的治疗. 在Ate/ Bev之后的局部转换疗法,包括手术或TACE/ HAIC,可能会提高不可切除的HCC患者的存活率.
科学领域:
- 肝胆外科手术
- 医疗瘤学
- 辐射瘤学
背景情况:
- 在治疗不可切除的肝细胞癌 (HCC) 方面,阿特佐利祖马布加贝瓦齐祖马布 (Ate/ Bev) 已成为显著的进展.
- "ABC转换"的概念涉及使用Ate/Bev治疗后的治疗方法.
- 最佳的Ate/Bev后治疗策略需要进一步研究.
研究的目的:
- 评估各种Ate/ Bev后治疗策略在不可切除的HCC患者中的有效性.
- 将Ate/ Bev治疗后不同治疗方式的生存结果进行比较.
- 评估"局部转换"疗法对患者生存的影响.
主要方法:
- 分析了一组149名用Ate/ Bev治疗的无法切除的HCC患者.
- 患者被分为六组:无药,手术,放射治疗,透管动脉化学栓塞/肝动脉输液化疗 (TACE/HAIC),化疗和最佳支持性治疗 (BSC).
- 当地转换组 (手术,放射治疗,TACE/HAIC) 还被分为治疗和缓解的意图.
主要成果:
- 三年总生存率 (OS) 在不同组之间有显著差异,无药组显示为100. 0%和BSC组显示为10. 1%.
- 与其他组 (16. 3个月) 相比,接受局部转换治疗的患者的中位生存时间明显更长 (28. 0个月).
- 虽然治愈局部转换显示出比息局部转换更好的预后趋势,但这种差异在统计上并不显著 (p=0. 155).
结论:
- 在Ate/ Bev治疗后,局部转换策略,包括手术,放射治疗和TACE/ HAIC可能会改善不可切除的HCC患者的生存结果.
- 即使治疗方法是不可行的,缓解局部转换仍然可以提供临床益处.
- 需要进行进一步的研究,以优化Ate/Bev后治疗方案的选择和排序.
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