利用综合治疗措施进一步提高肝癌肝移植疗效  

Improving efficacy of liver transplantation for hepatocellular carcinoma by comprehensive treatment

作　　者：汪根树[1] Wang Genshu(Department of Hepatic Surgery,Liver Transplantation Center,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院肝脏外科暨肝移植中心,广州510630

出　　处：《器官移植》2021年第3期249-256,共8页Organ Transplantation

基　　金：国家自然科学基金(81170422、81870447);广东省科技计划项目(2017A020215178)。

摘　　要：超标准原发性肝癌(肝癌)病人的肝移植机会、符合标准的肝癌病人等待肝移植期间因肝癌进展脱失和肝癌肝移植术后复发是当前肝癌肝移植面临的重要问题。近年来仑伐替尼等系统治疗药物及其联合其它治疗的综合治疗在晚期肝癌治疗中获得了突破性疗效,也为肝癌肝移植的降期治疗、桥接治疗和肿瘤复发防治带来了新的希望。基于系统治疗药物的综合治疗可能是提高肝癌肝移植疗效的突破点,值得深入研究。本文介绍了肝癌肝移植的降期治疗、桥接治疗和肿瘤复发防治进展,旨在为临床治疗提供参考。Currently,several major challenges still exist in liver transplantation for hepatocellular carcinoma(HCC),including the opportunity of liver transplantation for HCC patients beyond selection criteria,drop-out from the waiting list for HCC patients within selection criteria due to tumor progression and the tumor recurrence after liver transplantation.In recent years,revolutionary efficacy has been achieved in treating advanced HCC by employing systemic drugs,such as lenvatinib and systemic drug-based comprehensive treatment,which also sheds light on the down-staging therapy and bridging therapy for HCC patients listed for liver transplantation,and prevention and treatment of tumor recurrence after liver transplantation for HCC individuals.Systemic drug-based comprehensive treatment probably has the potential to improve the clinical efficacy of liver transplantation for HCC,which deserves in-depth investigation.In this review,we summarize the progress on down-staging therapy,bridging therapy as well as prevention and treatment of tumor recurrence after liver transplantation for HCC individuals,aiming to provide reference for clinical management of HCC.

关 键 词：肝细胞癌 肝移植 降期治疗 桥接治疗 综合治疗 经导管动脉化疗栓塞(TACE) 细胞毒T淋巴细胞相关抗原(CTLA) 程序性细胞死亡蛋白1(PD-1) 索拉非尼 仑伐替尼 立体定向体部放疗(SBRT) 酪氨酸激酶抑制剂(TKI) 

分 类 号：R617[医药卫生—外科学] R575[医药卫生—临床医学]