复合式冷热消融系统治疗原发性肝癌中国专家共识（2023）

中国抗癌协会肿瘤微创治疗专业委员会; 中国抗癌协会肿瘤消融治疗专业委员会

复合式冷热消融系统治疗原发性肝癌中国专家共识（2023）

基金项目:

国家重点研发计划资助 (2020YFC0122305)

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出版历程
- 收稿日期: 2023-11-06
- 录用日期: 2023-12-06
- 出版日期: 2023-12-12

Chinese expert consensus on Co-Ablation System for the treatment of primary liver cancer （2023 edition）

Research funding:

National Key Research and Development Program (2020YFC0122305)

摘要

摘要: 局部消融术后复发和转移是影响肝癌患者远期生存的主要因素。新一代复合式冷热消融系统（康博刀）整合了深低温冷消融和热消融的优点，彻底破坏原位肝癌的同时最大程度释放肿瘤抗原，以达到控制肝癌复发和转移的目的。复合式冷热消融通常在超声或CT引导下经皮穿刺进行，根据肿瘤大小及部位选择局部麻醉或全身麻醉方式，主要适合于单发肿瘤直径<5 cm，多发肿瘤（≤3枚）最大直径<3 cm者。术后根据情况给予保肝及对症等治疗，1个月左右通过肝脏MRI或增强CT评估疗效并进入后期随访。为规范复合式冷热消融系统在肝癌中的应用，经中国抗癌协会肿瘤微创治疗专业委员会和肿瘤消融治疗专业委员会肝癌消融治疗专家充分讨论后达成本专家共识。
- 原发性肝癌 /
- 复合式冷热消融系统 /
- 操作规范 /
- 专家共识
Abstract: Clinically， the recurrence and metastasis of liver cancer after local ablation therapy have been the main factors affecting the long-term survival of patients with liver cancer. As a new generation of composite cryoablation and thermal ablation system， Co-Ablation System creatively integrates the advantages of profound hypothermia cryoablation and thermal ablation， which can maximize the release of tumor antigen while completely destroying liver cancer in situ， thus， the purpose of controlling liver cancer recurrence and metastasis can be achieved. Co-Ablation System treatment is usually carried out through percutaneous puncture under ultrasound or CT guidance. The selection of local anesthesia or general anesthesia is based on the size and location of the liver cancer. Co-Ablation System treatment is mainly suitable for single tumor with diameter <5 cm and multiple tumors（≤3 tumor lesions） with a maximum diameter <3 cm. After ablation， protection of liver function and symptomatic treatment are employed according to patient’s condition. About one month after ablation， MRI or contrast-enhanced CT examination is performed to evaluate the therapeutic efficacy， then， the patients are followed up regularly. In order to standardize the application of Co-Ablation System in treating liver cancer， the Committee of Minimally Invasive Therapy in Oncology and the Committee of Ablation Therapy in Oncology， Chinese Anti-Cancer Association， have organized domestic experts engaged in liver cancer ablation therapy to make a professional and in-depth discussion and to compose this expert consensus on Co-Ablation System for the treatment of primary liver cancer.
- Primary Liver Cancer /
- Co-Ablation System /
- Operation Specification /
- Expert Consensus

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参考文献(22)

[1]	ZHOU MG, WANG HD, ZENG XY, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394( 10204): 1145- 1158. DOI: 10.1016/S0140-6736(19)30427-1.
[2]	CHEN WQ, ZHENG RS, BAADE PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66( 2): 115- 132. DOI: 10.3322/caac.21338.
[3]	BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68( 6): 394- 424. DOI: 10.3322/caac.21492.
[4]	ZOU YW, REN ZG, SUN Y, et al. The latest research progress on minimally invasive treatments for hepatocellular carcinoma[J]. Hepatobiliary Pancreat Dis Int, 2023, 22( 1): 54- 63. DOI: 10.1016/j.hbpd.2022.08.004.
[5]	QIAN K, ZHANG F, ALLISON SK, et al. Image-guided locoregional non-intravascular interventional treatments for hepatocellular carcinoma: Current status[J]. J Interv Med, 2021, 4( 1): 1- 7. DOI: 10.1016/j.jimed.2020.10.008.
[6]	CHEN MS, LI JQ, ZHENG Y, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma[J]. Ann Surg, 2006, 243( 3): 321- 328. DOI: 10.1097/01.sla.0000201480.65519.b8.
[7]	FENG K, YAN J, LI XW, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma[J]. J Hepatol, 2012, 57( 4): 794- 802. DOI: 10.1016/j.jhep.2012.05.007.
[8]	Bureau of Medical Administration, National Health Commission of the People’s Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China(2019 edition)[J]. J Clin Hepatol, 2020, 36( 2): 277- 292. DOI: 10.3969/j.issn.1001-5256.2020.02.007. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范(2019年版)[J]. 临床肝胆病杂志, 2020, 36( 2): 277- 292. DOI: 10.3969/j.issn.1001-5256.2020.02.007.
[9]	EL-AGAWY W, EL-GANAINY SA, GAD MAA, et al. Combined transarterial chemoembolization with microwave ablation versus microwave alone for treatment of medium sized hepatocellular carcinoma[J]. Curr Cancer Drug Targets, 2022, 22( 1): 77- 85. DOI: 10.2174/1568009622666220117094146.
[10]	ZHU SD, ZHENG L. Advances in clinical application of percutaneous thermal ablation for hepatocellular carcinoma[J]. J Interv Radiol, 2022, 31( 12): 1224- 1227. DOI: 10.3969/j.issn.1008-794X.2022.12.020. 朱诗迪, 郑琳. 经皮穿刺热消融术在肝细胞癌中的临床应用进展[J]. 介入放射学杂志, 2022, 31( 12): 1224- 1227. DOI: 10.3969/j.issn.1008-794X.2022.12.020.
[11]	LIU J, ZHOU Y, YU T, et al. Minimally invasive probe system capable of performing both cryosurgery and hyperthermia treatment on target tumor in deep tissues[J]. Minim Invasive Ther Allied Technol, 2004, 13( 1): 47- 57. DOI: 10.1080/13645700310022691.
[12]	CHU KF, DUPUY DE. Thermal ablation of tumours: Biological mechanisms and advances in therapy[J]. Nat Rev Cancer, 2014, 14( 3): 199- 208. DOI: 10.1038/nrc3672.
[13]	YAN JF, DENG ZS, LIU J, et al. New modality for maximizing cryosurgical killing scope while minimizing mechanical incision trauma using combined freezing-heating system[J]. J Med Devices, 2007, 1( 4): 264- 271. DOI: 10.1115/1.2812423.
[14]	CHEN ZN, MENG LL, ZHANG J, et al. Progress in the cryoablation and cryoimmunotherapy for tumor[J]. Front Immunol, 2023, 14: 1094009. DOI: 10.3389/fimmu.2023.1094009.
[15]	ZHU J, ZHANG Y, ZHANG AL, et al. Cryo-thermal therapy elicits potent anti-tumor immunity by inducing extracellular Hsp70-dependent MDSC differentiation[J]. Sci Rep, 2016, 6: 27136. DOI: 10.1038/srep27136.
[16]	SHEN YY, LIU P, ZHANG AL, et al. Tumor microvasculature response to alternated cold and heat treatment[J]. Conf Proc IEEE Eng Med Biol Soc, 2005, 2005: 6797- 6800. DOI: 10.1109/IEMBS.2005.1616065.
[17]	DONG JX, LIU P, ZHANG AL, et al. Immunological response induced by alternated cooling and heating of breast tumor[J]. Conf Proc IEEE Eng Med Biol Soc, 2007, 2007: 1491- 1494. DOI: 10.1109/IEMBS.2007.4352583.
[18]	LIU K, HE K, XUE T, et al. The cryo-thermal therapy-induced IL-6-rich acute pro-inflammatory response promoted DCs phenotypic maturation as the prerequisite to CD4⁺ T cell differentiation[J]. Int J Hyperthermia, 2018, 34( 3): 261- 272. DOI: 10.1080/02656736.2017.1332394.
[19]	Committee of Minimally Invasive Therapy in Oncology, Chinese AntiCancer Association. Chinese College of Interventionalists;Expert Committee on Interventional Therapy, Chinese Society of Clinical Oncolog(CSCO), et al. Expert consensus on clinical practice of multi-model ablation for treatment of liver malignant tumors[J]. Chin J Interv Imag Ther, 2021, 18( 1): 23- 27. DOI: 10.13929/j.issn.1672-8475.2021.01.006. 中国抗癌协会肿瘤介入学专业委员会, 中国医师协会介入医师分会, 中国临床肿瘤学会(CSCO)放射介入治疗专家委员会, 等. 冷热多模态消融治疗肝脏恶性肿瘤操作规范专家共识[J]. 中国介入影像与治疗学, 2021, 18( 1): 23- 27. DOI: 10.13929/j.issn.1672-8475.2021.01.006.
[20]	Committee of Minimally Invasive Therapy in Oncology, Chinese AntiCancer Association. Chinese College of Interventionalists; Expert Committee on Interventional Therapy, Chinese Society of Clinical Oncolog(CSCO), et al. Expert consensus on clinical practice of percutaneous multi-modal cold and hot ablation for treatment of pulmonary malignant tumor[J]. Chin J Interv Imag Ther, 2020, 17: 705- 710. DOI: 10.13929/j.issn.1672-8475.2021.01.006. 中国抗癌协会肿瘤介入学专业委员会, 中国医师协会介入医师分会, 中国临床肿瘤学会(CSCO)放射介入治疗专家委员会, 等. 经皮穿刺冷热多模态消融治疗肺部恶性肿瘤操作规范专家共识[J]. 中国介入影像与治疗学, 2020, 17: 705- 710. DOI: 10.13929/j.issn.1672-8475.2021.01.006.
[21]	The Society of Interventional Therapy, China Anticancer Association, The Solid Tumor Theranostics Committee, Shanghai Anticancer Association. Expert consensus on the imaging-guided multimode tumor ablation therapy system for malignant hepatic tumors[J]. J Interv Radiol, 2018, 27( 7): 603- 607. DOI: 10.3969/j.issn.1008-794X.2018.07.001. 中国抗癌协会肿瘤介入学专业委员会, 上海市抗癌协会实体肿瘤聚焦诊疗专业委员会. 影像导引肝脏恶性肿瘤多模态消融治疗技术专家共识[J]. 介入放射学杂志, 2018, 27( 7): 603- 607. DOI: 10.3969/j.issn.1008-794X.2018.07.001.
[22]	YANG WW, AN YH, LI QW, et al. Co-ablation versus cryoablation for the treatment of stage Ⅲ-Ⅳ non-small cell lung cancer: A prospective, noninferiority, randomized, controlled trial(RCT)[J]. Thorac Cancer, 2021, 12( 4): 475- 483. DOI: 10.1111/1759-7714.13779.