[Current therapy of hepatocellular carcinoma with special consideration of new and multimodal treatment concepts].
[Current therapy of hepatocellular carcinoma with special consideration of new and multimodal treatment concepts].
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DOI：
10.1055/s-0033-1343232
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发表时间：
2013-07-01
期刊：
影响因子：
--
通讯作者：
Erhardt, A
中科院分区：
文献类型：
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作者：
Gobel, T;Blondin, D;Erhardt, A
由于丙型肝炎相关的肝细胞癌（HCC）的数量不断增加，肝细胞癌（HCC）的发病率在全球范围内不断增加。在超过80%的患者中，HCC发生在肝硬化中。此外，超过一半的患者在初次诊断时具有晚期Child-Pugh评分或不可手术的肿瘤分期。国家和国际指南对HCC治疗的建议依赖于BCLC（“巴塞罗那肝癌诊所”）算法。根据肝功能和肿瘤疾病的阶段，它建议切除，肝移植，射频热消融（RFA），经动脉化疗栓塞（TACE），索拉非尼全身治疗或最佳支持治疗，但不考虑联合治疗或新的治疗方式。然而，越来越多的证据表明，组合I。e.索拉非尼与TACE或局部区域技术组合与单一疗法相比增强了有效性和肿瘤控制。使用药物洗脱珠的TACE、选择性内部放射治疗（SIRT）和新的局部治疗程序（如微波消融术（MWA））是更有前途的治疗方法。HCC患者应在当地肿瘤委员会进行讨论，以提供最佳和最个性化的治疗方法。
The incidence of hepatocellular carcinoma (HCC) is increasing worldwide due to the growing number of hepatitis C related HCCs. In more than 80% of the patients, HCC arises in a cirrhotic liver. Furthermore, more than half of the patients have an advanced Child-Pugh score or an inoperable tumor stage at the initial diagnosis. Recommendations for the treatment of HCC by national and international guidelines rely on the BCLC ("Barcelona Clinic for Liver Cancer") algorithm. Depending on the stage of liver function and tumor disease it recommends resection, liver transplantation, radiofrequency thermal ablation (RFA), transarterial chemoembolisation (TACE), systemic therapy with sorafenib or best supportive care, but does neither take into consideration combination of therapies nor new therapy modalities. However, there is increasing evidence that combinations i. e. sorafenib with TACE or combination of locoregional techniques enhance effectivity and tumor control compared to monotherapies. TACE with drug-eluting beads, selective internal radiotherapy (SIRT) and new locoregional therapy procedures like microwave ablation (MWA) are further promising therapeutic approaches. Patients with HCC should be discussed in a local tumor board in order to provide the optimal and most individual way of treatment.