New progress in treatment of hepatocellular carcinoma with portal vein tumor thrombus
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摘要: 门静脉癌栓是肝细胞癌晚期患者常见表现之一,是导致严重并发症的决定性因素,预后极差。随着分子生物学及影像学技术的发展,外科手术切除、介入栓塞化疗、放射治疗、各种消融治疗、分子靶向治疗等手段,无论单一应用还是综合治疗均取得了丰硕成果,但目前仍缺乏合理有效的治疗规范。对近些年来关于肝细胞癌合并门静脉癌栓的治疗新进展做出总结,希望能为今后治疗方案的规范化提供参考。Abstract: Portal vein tumor thrombus( PVTT) is one of the common manifestations in patients with advanced hepatocellular carcinoma( HCC). It is the decisive factor leading to severe complications and causes extremely poor prognosis. With the development of molecular biology and imaging techniques,both single and combined therapy modalities,including surgical resection,embolization and chemotherapy,radiation therapy,a variety of ablation therapies,and molecular targeted therapy,have achieved substantial progress. However,there are no guidelines for reasonable and effective treatments. In this paper,new progress in the treatment of HCC with PVTT in recent years is summarized to provide a standardized approach for future treatment options.
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Key words:
- carcinoma,hepatocellular /
- portal vein tumor thrombosis /
- therapy /
- review
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[1]XIAO KM,PENG MH.The progress of treatment for primary liver cancer with portal vein tumor thrombus[J].Chin J Bases Clin Gen Surg,2012,19(3):259-265.(in Chinese)肖开银,彭民浩.原发性肝癌合并门静脉癌栓的治疗进展[J].中国普外基础与临床杂志,2012,19(3):259-265. [2]RIM CH,YANG DS,PARK YJ,et al.Effectiveness of highdose three-dimensional conformal radiotherapy in hepatocellular carcinoma with portal vein thrombosis[J].JPn J Clin Oncol,2012,42(8):721-729. [3]SHUQUN C,MENGCHAOW,HAn C,et al.Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein[J].Hepatogastroenterology,2007,54(74):499-502. [4]SHI J,LAI EC,LI N,et al.A new classification for hepatocellular carcinoma with portal vein tumor thrombus[J].J Hepatobiliary Pancreat Sci,2011,18(1):74-80. [5]LEE SS,SHIN HS,KIM HJ,et al.Analysis of prognostic factors and 5-year survival rate in patients with hepatocellular carcinoma:a single-center experience[J].Korean J Hepatol,2012,18(1):48-55. [6]SHI J,LAI EC,LI N,et al.Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].Ann Surg Oncol,2010,17(8):2073-2080. [7]YOSHIDOME H,TAKEUCHI D,KIMURA F,et al.Treatment strategy for hepatocellular carcinoma with major portal vein or inferior vena cava invasion:a single institution experience[J].J Am Coll Surg,2011,212(5):796-803. [8]LUO J,GUO RP,LAI EC,et al.Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis:a prospective comparative study[J].Ann Surg Oncol,2011,18(2):413-420. [9]LIU Y,ZHANG YW,GUO Z.Preliminary clinical experience in TACE with gelatin sponge particles for treatment of liver cancer accompanied by portal vein tumor thrombus with abundant blood supply[J].Natl Med J China,2014,94(7):549-550.(in Chinese)刘影,张跃伟,郭志.微粒TACE治疗肝癌伴富血供门静脉癌栓的初步临床经验[J].中华医学杂志,2014,94(7):549-550. [10]KIM JY,CHUNG SM,CHOI BO,et al.Hepatocellular carcinoma with portalvein tumor thrombosis:improved treatment outcomes with external beam radiation therapy[J].Hepatol Res,2011,41(9):813.824. [11]NING XJ,YU HB,FENG XB,et al.Efficacy of three-dimensional conformal radiotherapy in treatment of primary liver cancer with portal vein tumor thrombus and analysis of prognostic factors[J].J South Med Univ,2010,30(9):2196-2198.(in Chinese)宁雪坚,于洪波,冯献斌,等.三维适形放疗治疗原发性肝癌伴门静脉癌栓的疗效及预后因素分析[J].南方医科大学学报,2010,30(9):2196-2198. [12]LIN GL,ZENG ZC,WU Z,et al.Three dimensional conformal radiothepapy for patients with portal vein tumor thrombosis[J].J Pract Oncol,2012,27(3):255-258.(in Chinese)林根来,曾昭冲,吴铮,等.三维适形放射治疗门静脉癌栓[J].实用肿瘤杂志,2012,27(3):255-258. [13]LING TC,KANG JI,BUSH DA,et al.Proton therapy for hepatocellular carcino ma[J].Chin J Cancer Res,2012,24(4):367-373. [14]SUGAHARA S,NAKAYAMA H,FUKUDA K,et al.Protonbeam therapy for hepato cellular carcinoma associated with portal vein tumor thrombosis[J].Strahlenther Onkol,2009,185(12):782-788. [15]MARELLI L,SHUSANG V,BUSCOMBE JR,et al.Transarterial iniection of(131)I-lipiodol,compared with ehemoembolization in the treatment of unreseetable hepatocellular cancer[J].J Nucl Med,2009,50(6):871-877. [16]PENG QR,XIAO B,WANG Z,et al.Short-term efficacy of125I Particle implantation in treatment of portal vein tumor thrombus:a report of 40 cases[J].Chin J Clin Oncol,2010,37(19):1115-1118.(in Chinese)彭齐荣,肖必,王峥,等.125I粒子植人术治疗门静脉癌栓40例近期疗效观察[J].中国肿瘤临床,2010,37(19):1115-1118. [17]TSAI AL,BURKE CT,KENNEDY AS,et al.Use of yttrium-90microspheres in patients with advanced hepatocellular carcinoma and portal vein thrombosis[J].J Vasc Interv Radiol,2010,21(9):1377-1384. [18]YAMAMOTO K,MASUZAWA M,KATO M,et al.Evaluation of combined therapy with chemoembolization and ethanol injection for advanced hepatocellular carcinoma[J].Sermin Oncol,1997,24(2 Suppl 6):s6-50-s6-55. [19]NING HB,LIU Z,LU HM,et al.Surgical resection versus radiofrequency ablation in the treatment of primary hepatocellular carcinoma with typeⅠportal vein tumor thrombus[J].Chin J Hepatobiliary Surg,2013,19(8):593-596.(in Chinese)宁海波,刘哲,卢海明,等.手术切除与射频消融对原发性肝癌合并Ⅰ型门静脉癌栓的临床疗效观察[J].中华肝胆外科杂志,2013,19(8):593-596. [20] LLOVET JM,RICCI S,MAZZAFERRO V,et al.Sorafenib in advanced hepatocellular carcinoma[J].N Engl J Med,2008,359(4):378-390. [21]IRTAN S,CHOPIN-LALY X,RONOT M,et al.Complete regression of locally advanced hepatocellular carcinoma induced by sorafenib allowing curative resection[J].Liver Int,2011,31(5):740-743. [22]KIM JY,CHUNG SM,CHOI BO,et al.Hepatocellular carcinoma with portal vein tumor thrombosis:improved treatment outcomes with external beam radiation therapy[J].Hepatol Res,2011,41(9):813-824. [23]ZHENG JS,SUN B,SHENG SP,et al.Combination therapy of primary liver cancer with portal vein tumor thrombus[J].Chin J Interv Imaging Ther,2011,8(2):86-89.(in Chinese)郑加生,孙斌,生守鹏,等.合并门静脉癌栓的原发性肝癌的综合介入治疗[J].中国介入影像与治疗学,2011,8(2):86-89. [24]CHEN JW,PANG PF,MENG XC,et al.Clinical observation of transcatheter arterial chemoembolization plus sorafenib in the treatment of advanced hepatocellular carcinoma with different types of portal vein tumor thrombosis[J].Natl Med J China,2013,93(9):663-667.陈俊伟,庞鹏飞,孟晓春,等.TACE联合索拉非尼治疗原发性肝癌合并不同分型门静脉癌栓的临床观察[J].中华医学杂志,2013,93(9):663-667.
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