原发性肝癌多学科整体治疗方案的设计与实施

王悦华

doi:10.3969/j.issn.1001-5256.2014.03.004

原发性肝癌多学科整体治疗方案的设计与实施

DOI: 10.3969/j.issn.1001-5256.2014.03.004

王悦华

首都医科大学宣武医院普外科

基金项目:

北京市卫生系统高层次卫生技术人才培养项目(2009-3-65)； 2011年首都医科大学宣武医院院级教学课题；

详细信息

中图分类号: R735.7
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出版历程
- 出版日期: 2014-03-20

Design and implementation of multidisciplinary holistic treatment regimen for primary liver cancer

Wang YueHua

Research funding:

摘要

摘要:
恶性肿瘤的治疗模式正在经历从传统的单项专科治疗向联合治疗,再向多学科综合治疗的转变。笔者提出了以整体医学观为基础的肿瘤多学科整体治疗(MDHT)模式以指导肿瘤综合治疗方案的设计与实施。MDHT模式涉及治疗目标、治疗方法和治疗疗程三个方面。以原发性肝癌为例,可以将整体治疗的靶向目标分为肿瘤局部病灶、区域病灶、系统病灶、器官基础病、全身内环境以及康复等六项基本目标。针对MDHT模式中各项治疗目标,可分别采用多种治疗方法的序贯疗法、同步治疗和交替疗法。整体治疗方案的实施是由不同治疗方法的多个治疗疗程来实现的。在肿瘤MDHT模式中,多学科治疗是治疗方式的体现,整体治疗是治疗目标的追求。MDHT的理念有助于指导多学科团队设计和实施肿瘤综合治疗方案。
- 癌,肝细胞 /
- 综合疗法 /
- 综述
Abstract:
The treatment modality for malignant tumor is changing from traditional single treatment to combined treatment and then to multidisciplinary comprehensive treatment. Based on the holistic medicine view, the author proposes the multidisciplinary holistic treatment ( MDHT) model to design and implement the comprehensive treatment regimen for cancer. The MDHT model involves three aspects: treatment target, treatment method, and treatment course. To take primary liver cancer as an example, the holistic treatment target can be divided into six basic targets: local lesion, regional lesions, systemic lesions, organ- based disease, homeostasis, and rehabilitation. Sequential therapy, synchronous therapy, and alternative therapy can be employed for the treatment targets of MDHT model. The implementation of holistic treatment regimen is achieved by different courses of multiple treatment methods. In the MDHT model for cancer, multidisciplinary treatment is the reflection of treatment modality, while holistic treatment is the treatment target pursued. The concept of MDHT contributes to the design and implementation of comprehensive treatment for cancer by multidisciplinary team.
- carcinoma, hepatocellular /
- combined modality therapy /
- review

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参考文献(23)

[1]WIGGANS MG, JACKSON SA, FOX BM, et al.The preoperative assessment of hepatic tumours:evaluation of UK regional multidisciplinary team performance[J].HPB Surg, 2013, 2013:861681.

[2]HIGGINS MC, SOULEN MC.Multimodality approaches for control of hepatocellular carcinoma[J].Tech Vasc Interv Radiol, 2007, 10 (1) :64-66.

[3]LAMB B, PAYNE H, VINCENT C, et al.The role of oncologists in multidisciplinary cancer teams in the UK:an untapped resource for teamleadership?[J].J Eval Clin Pract, 2011, 17 (6) :1200-1206.

[4]WU YL.Challenge of malignant neoplasm synthetic therapy[J].J Evid-based Med, 2008, 8 (1) :1-2. (in Chinese) 吴一龙.恶性肿瘤多学科综合治疗的困境[J].循证医学, 2008, 8 (1) :1-2.

[5]WANG YH.Classification of multidisciplinary synthetic therapy and creation of aggregate treatment mode for hepatocellular carcinoma[J].Chin J Hepatobiliary Surg, 2010, 16 (4) :270-274. (in Chinese) 王悦华.肝癌多学科综合治疗的分级与集合治疗模式的建立[J].中华肝胆外科杂志, 2010, 16 (4) :270-274.

[6]WANG YH, LIU JF, LI F, et al.Radiofrequency ablation combined with transarterial chemoembolization for unresectable primary liver cancer[J].CMJ, 2009, 122 (8) :889-894.

[7]CUCCHETTI A, PISCAGLIA F, CESCON M, et al.Systematic review of surgical resection vs radiofrequency ablation for hepatocellular carcinoma[J].World J Gastroenterol, 2013, 19 (26) :4106-4118.

[8]MAS VR, MALUF DG, DUMUR CI, et al.Molecular techniques for identifying HCC origin and biology after orthotopic liver transplantation[J].Diagn Mol Pathol, 2006, 15 (2) :90-94.

[9]SHIN JW, CHUNG YH.Molecular targeted therapy for hepatocellular carcinoma:current and future[J].World J Gastroenterol, 2013, 19 (37) :6144-6155.

[10]LIU MT, LI SH, CHU TC, et al.Three-dimensional conformal radiation therapy for unresectahle hepatocellular carcinoma patients who had failed with or were unsuited for transcatheter arterial chemoemholization[J].Jpn J Clin Oncol, 2004, 34 (9) :532-539.

[11]SALEM R, LEWANDOWSKI RJ, KULIK L, et al.Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma[J].Gastroenterology, 2011, 140 (2) :497-507.

[12]YANG W, SHEN ZQ, WANG JY, et al.Current progress in CIK anticancer cytotherapeutic protocol in China[J].Sci Technol Rev, 2008, 26 (6) :73-77. (in Chinese) 杨葳, 沈志奇, 王俊懿, 等.我国新型肿瘤细胞治疗方法CIK的研究与应用现状[J].科技导报, 2008, 26 (6) :73-77.

[13]THOMAS MB, O'BEIRNE JP, FURUSE J, et al.Systemic therapy for hepatocellular carcinoma:cytotoxic chemotherapy, targeted therapy and immunotherapy[J].Ann Surg Oncol, 2008, 15 (4) :1008-1014.

[14] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B (2010 version) [J].J Clin Hepatol, 2011, 27 (1) :1-16. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2010年版) [J].临床肝胆病杂志, 2011, 27 (1) :1-16.

[15]DONG J, JIANG JJ.Explanation of the“Recommendation on antiviral therapy to hepatitis B/C virus related hepatocellular carcinoma”[J].J Clin Hepatol, 2013, 29 (1) :20-24. (in Chinese) 董菁, 江家骥.《HBV/HCV相关性肝细胞癌抗病毒治疗专家建议》解读[J].临床肝胆病杂志, 2013, 29 (1) :20-24.

[16]KORANGY F, HCHST B, MANNS MP, et al.Immunotherapy of hepatocellular carcinoma[J].Expert Rev Gastroenterol Hepatol, 2010, 4 (3) :345-353.

[17]LUK JM, WANG X, LIU P, et al.Traditional Chinese herbal medicines for treatment of liver fibrosis and cancer:from laboratory discovery to clinical evaluation[J].Liver Int, 2007, 27 (7) :879-890.

[18]WANG JS, SUN GZ, YAO NL, et al.Treatment of liver cancer by traditional Chinese medicine[J].Jilin J Tradit Chin Med, 2013, 33 (12) :1209-1211. (in Chinese) 王靖思, 孙桂芝, 姚乃礼, 等.肝癌的中医治疗[J].吉林中医药, 2013, 33 (12) :1209-1211.

[19]MARTIN RC, EID S, SCOGGINS CR, et al.Health-related quality of life:return to baseline after major and minor liver resection[J].Surgery, 2007, 142 (5) :676-684.

[20]WANG YH, WANG YJ, ZHENG YM, et al.Clinical thinking training in problem-based learning in multi-disciplinary diagnosis and treatment of hepatocellular carcinoma[J].China Med Education Technol, 2010, 24 (4) :408-411. (in Chinese) 王悦华, 王亚军, 郑亚民, 等.肝细胞癌多学科诊疗临床思维方法的PBL教学体会[J].中国医学教育技术, 2010, 24 (4) :408-411.

[21]Ministry of Health of the People’s Republic of China.Diagnosis, management and treatment of hepatocellular carcinoma (2011 version) [J].J Clin Hepatol, 2011, 27 (11) :1141-1159. (in Chinese) 中华人民共和国卫生部.原发性肝癌诊疗规范 (2011年版) [J].临床肝胆病杂志, 2011, 27 (11) :1141-1159.

[22]LAMB B, GREEN JS, VINCENT C, et al.Decision making in surgical oncology[J].Surg Oncol, 2011, 20 (3) :163-168.

[23]GENNARI L.Therapeutic approach to hepatocellular carcinoma:a difficult choice[J].Ann Ital Chir, 2008, 79 (2) :79-80.

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