基于TACE/HAIC治疗的转化疗法,以改善最初无法切除的肝细胞癌的治疗效果
Shuirong Lin1, Zimin Song1, Peizhe Chen1,2
1Center of Hepato-Pancreato-biliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China.
Liver cancer
|October 9, 2025
概括
透管动脉化学栓塞/肝动脉输液化疗联合治疗可以将不可切除的肝细胞癌 (HCC) 转化为可切除的,显著改善肝切除后的长期存活率. 这种方法为晚期HCC患者提供了有前途的治疗潜力.
科学领域:
- 肝胆道手术 肝胆道手术
- 干预性放射学 干预性放射学
- 医学瘤学 医学瘤学
背景情况:
- 肝细胞癌 (HCC) 构成了重大挑战,特别是在其不可切除的形式.
- 对于不可切除的HCC的标准治疗通常具有有限的长期疗效.
- 转化疗法旨在使最初无法切除的瘤适应治愈切除.
研究的目的:
- 为了评估无法切除的HCC患者的结局,他们接受过导管动脉化学栓塞 (TACE) /肝动脉输液化疗 (HAIC) 基础的组合治疗.
- 评估转化疗法后肝切除对患者存活时间的影响.
- 确定成功转换为手术切除的预测因素.
主要方法:
- 对301名最初无法切除的HCC患者进行了回顾性审查,这些患者接受了TACE/HAIC治疗 (2019-2021年).
- 对切除转化率,瘤负担变化和生存结果 (OS,PFS) 的分析.
- 多变量后勤回归用于识别成功转换手术的预测因素.
主要成果:
- 20.9%的患者实现了转换为肝切除.
- 手术切除导致了高度的病理完整反应 (31.7%) 和R0切除率 (100%).
- 与未切除的患者相比,切除的患者显示出显著改善的中位数OS (未达到vs.58.5个月) 和PFS (42.83vs9.7个月) 与未切除的患者相比.
结论:
- 基于TACE/HAIC的联合治疗有效地将不可切除的HCC转化为可切除的状态.
- 转化疗法后的肝切除显著提高了HCC患者的长期存活率.
- 成功转换手术的预测因素包括年龄,HBsAg状态,AFP水平,ECOG PS,BCLC阶段和炎症标志物.
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