中晚期肝细胞癌以TACE为基础的综合治疗  

TACE-based combination therapies in the management of intermediate-advanced stage hepatocellular carcinoma

作　　者：仲斌演 滕皋军[2] ZHONG Binyan;TENG Gaojun(Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China;Centerof Interventional and Vascular Surgery,Department of Radiology,Zhongda Hospital,Medical School Southeast University,Nanjing,Jiangsu Province 210009,China)

机构地区：[1]苏州大学附属第一医院介入科,江苏苏州215006 [2]东南大学附属中大医院介入与血管外科

出　　处：《介入放射学杂志》2025年第1期1-4,共4页Journal of Interventional Radiology

摘　　要：经动脉化疗栓塞(TACE)在中晚期肝细胞癌(HCC)的治疗中发挥着重要作用。基于TACE术后肿瘤内部缺氧环境导致血管内皮生长因子增加,使TACE术后病灶进展风险增加这一情况,TACE联合抗血管生成药物治疗中晚期HCC理论上可起到协同增效作用。然而,这方面的研究大多以失败告终。近年来,免疫治疗在HCC领域取得的进展突破,这既推动了TACE治疗,也面临着全身系统治疗的新挑战。考虑到两者间潜在的协同作用机制,TACE联合免疫治疗为主的系统治疗可能比单一治疗更能提高对中晚期HCC患者的疗效。该文结合以TACE为基础的综合治疗这一领域现有的研究证据,讨论已发表和正在进行的研究中关于TACE联合治疗的证据,探讨基于TACE的综合治疗在中晚期HCC患者治疗中的协同疗效及重要地位。Clinically,transarterial chemoembolization(TACE)plays a crucial role in the treatment of intermediate-advanced stage hepatocellular carcinoma(HCC),and it is the most widely used therapeutic approach in clinical practice.Based on the fact that the hypoxic environment inside the tumor after TACE leads to an increase of the vascular endothelial growth factor,thereby increasing the risk of tumor progression,TACE combined with anti-angiogenic agents might theoretically have a synergistic effect.Nevertheless,most trials on this topic have failed.In recent years,immunotherapy-based systemic therapy has made breakthrough in the field of HCC treatment,which not only promotes TACE treatment,but also makes physicians to face the challenges of new general systemic treatment.Considering that the two treatments may have potential synergistic mechanism,the combination use of TACE and immunotherapy-based systemic therapy may be superior to the use of only one of the two treatment methods in improving the curative effect in patients with intermediate-advanced stage HCC.This article aims to make a detailed review about the current evidence in the field of TACE-based combination therapies and to discuss the published and ongoing trials concerning the combination use of TACE and systemic treatments,focusing on the synergistic efficacy and the important role of TACEbased combination therapies in treating patients with intermediate-advanced-stage HCC.

关 键 词：肝细胞癌 经动脉化疗栓塞 免疫治疗 系统治疗 

分 类 号：R735.7[医药卫生—肿瘤]