PDF(Pubmed)
Abstract：
Hepatocellular carcinoma (HCC) accounts for 90% of liver cancer cases worldwide and is currently the most quickly increasing cause of cancer-related deaths in the United States. The 5-year survival rate for primary liver cancer is estimated to be below 20%, and HCC mortality is expected to increase by 41% by 2040. Currently, surgical resection is the first-line approach to definitive treatment of early-stage HCC. However, the majority of patients present with late-stage, unresectable disease due to the asymptomatic nature of early HCC. For patients who present with unresectable HCC, locoregional therapies such as transarterial chemoembolization (TACE) represent an alternative approach to HCC treatment. TACE is a minimally invasive, catheter-based technique that allows for targeted delivery of chemotherapy to tumor sites while occluding tumor-feeding blood vessels. In appropriately selected patients, outcomes for TACE therapy have been shown to be more favorable than supportive care or conservative management. The increasing incidence and mortality of HCC, in addition to the late-stage presentation of most HCC patients, demonstrates the need to expand the role of locoregional therapies in the treatment of HCC. TACE represents an appealing approach to HCC management, including disease control, palliation, and potentially curative-intent strategies. In this review, we will describe the current utility of TACE in the treatment of HCC, characterize the outcomes of patients treated with TACE across different HCC stages, and outline future applications of TACE in the treatment paradigm.
摘要：
肝细胞癌（HCC）占全球肝癌病例的90％，目前是美国癌症相关死亡的最快增长原因。原发性肝癌的5年生存率估计低于20%。预计到2040年，HCC死亡率将增加41%。目前,手术切除是明确治疗早期HCC的一线方法.然而,大多数患者出现晚期，由于早期HCC的无症状性质，无法切除的疾病。对于患有不可切除HCC的患者，局部治疗如经动脉化疗栓塞(TACE)是HCC治疗的一种替代方法.TACE是一种微创的，基于导管的技术，可以将化疗药物靶向递送到肿瘤部位，同时阻塞肿瘤供血血管。在适当选择的患者中，TACE治疗的结局已被证明比支持治疗或保守治疗更有利.肝癌的发病率和死亡率不断上升，除了大多数肝癌患者的晚期表现，证明有必要扩大局部治疗在HCC治疗中的作用。TACE代表了一种吸引人的HCC管理方法，包括疾病控制,姑息治疗,和潜在的治疗意图策略。在这次审查中,我们将描述TACE在肝癌治疗中的当前效用，表征不同肝癌分期TACE治疗患者的预后，并概述了TACE在治疗范式中的未来应用。
