经肝动脉灌注化疗(HAIC)治疗经肝动脉化疗栓塞(TACE)抵抗肝细胞肝癌(HCC)患者的价值
The Value of Hepatic Artery Infusion Chemotherapy (HAIC) in the Treatment of Patients with Hepatocellular Carcinoma (HCC) Resistant to Transcatheter Arterial Chemoembolization (TACE)
DOI: 10.12677/acm.2025.153619, PDF,   
作者: 蒋 鹏：重庆医科大学第一临床学院，重庆；段建学*：重庆医科大学第一临床学院，重庆；重庆市垫江县人民医院肝胆外科，重庆
关键词: TACE抵抗；HAIC；肝细胞肝癌；TACE Resistance； HAIC； Hepatocellular Carcinoma
摘要: 经肝动脉栓塞化疗(Transcatheter Arterial Chemoembolization, TACE)是目前全球范围内中晚期肝细胞肝癌(Hepatocellular Carcinoma, HCC)推荐的一线治疗方式，但由于中晚期HCC患者在肿瘤负荷和肝功能等方面存在较大的差异性，部分患者在接受多次TACE治疗后，靶病灶无法取得控制，为避免重复无效的TACE治疗影响患者肝功能及预后，TACE抵抗的概念被提出。当HCC患者发生TACE抵抗后，需及时终止TACE治疗而转换为其他治疗方式。在本篇综述中，主要探讨经肝动脉灌注化疗(Hepatic Artery Infusion Chemotherapy, HAIC)在治疗发生TACE抵抗的HCC患者中的价值。
Abstract: Transcatheter arterial chemoembolization (TACE) is currently the recommended first-line treatment for advanced hepatocyte carcinoma (HCC) worldwide. However, due to the significant heterogeneity in tumor burden and liver function among advanced HCC patients, some patients fail to control the target lesions after multiple TACE treatments. To avoid repetitive ineffective TACE treatments that may affect liver function and prognosis, the concept of TACE resistance has been proposed. Once HCC patients develop TACE resistance, TACE treatment should be promptly terminated and switched to other treatment modalities. In this review, the value of hepatic artery infusion chemotherapy (HAIC) in treating HCC patients with TACE resistance is mainly discussed.
文章引用：蒋鹏, 段建学. 经肝动脉灌注化疗(HAIC)治疗经肝动脉化疗栓塞(TACE)抵抗肝细胞肝癌(HCC)患者的价值[J]. 临床医学进展, 2025, 15(3): 324-330. https://doi.org/10.12677/acm.2025.153619

参考文献

[1] Zhou, M., Wang, H., Zeng, X., Yin, P., Zhu, J., Chen, W., et al. (2019) Mortality, Morbidity, and Risk Factors in China and Its Provinces, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet, 394, 1145-1158. [Google Scholar] [CrossRef] [PubMed]
[2] Rumgay, H., Arnold, M., Ferlay, J., Lesi, O., Cabasag, C.J., Vignat, J., et al. (2022) Global Burden of Primary Liver Cancer in 2020 and Predictions to 2040. Journal of Hepatology, 77, 1598-1606. [Google Scholar] [CrossRef] [PubMed]
[3] Meyer, T., Fox, R., Ma, Y.T., Ross, P.J., James, M.W., Sturgess, R., et al. (2017) Sorafenib in Combination with Transarterial Chemoembolisation in Patients with Unresectable Hepatocellular Carcinoma (TACE 2): A Randomised Placebo-Controlled, Double-Blind, Phase 3 Trial. The Lancet Gastroenterology & Hepatology, 2, 565-575. [Google Scholar] [CrossRef] [PubMed]
[4] Vilgrain, V., Pereira, H., Assenat, E., Guiu, B., Ilonca, A.D., Pageaux, G., et al. (2017) Efficacy and Safety of Selective Internal Radiotherapy with Yttrium-90 Resin Microspheres Compared with Sorafenib in Locally Advanced and Inoperable Hepatocellular Carcinoma (SARAH): An Open-Label Randomised Controlled Phase 3 Trial. The Lancet Oncology, 18, 1624-1636. [Google Scholar] [CrossRef] [PubMed]
[5] Kudo, M., Han, K., Ye, S., Zhou, J., Huang, Y., Lin, S., et al. (2020) A Changing Paradigm for the Treatment of Intermediate-Stage Hepatocellular Carcinoma: Asia-Pacific Primary Liver Cancer Expert Consensus Statements. Liver Cancer, 9, 245-260. [Google Scholar] [CrossRef] [PubMed]
[6] Lee, J.S., Kim, B.K., Kim, S.U., Park, J.Y., Ahn, S.H., Seong, J.S., et al. (2020) A Survey on Transarterial Chemoembolization Refractoriness and a Real-World Treatment Pattern for Hepatocellular Carcinoma in Korea. Clinical and Molecular Hepatology, 26, 24-32. [Google Scholar] [CrossRef] [PubMed]
[7] 国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版) [J]. 临床肝胆病杂志, 2022, 38(2): 288-303.
[8] Kudo, M., Matsui, O., Izumi, N., Kadoya, M., Okusaka, T., Miyayama, S., et al. (2014) Transarterial Chemoembolization Failure/Refractoriness: JSH-LCSGJ Criteria 2014 Update. Oncology, 87, 22-31. [Google Scholar] [CrossRef] [PubMed]
[9] Park, J., Amarapurkar, D., Chao, Y., Chen, P., Geschwind, J.H., Goh, K.L., et al. (2013) Consensus Recommendations and Review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (Epoihcc). Liver International, 33, 327-337. [Google Scholar] [CrossRef] [PubMed]
[10] Raoul, J., Gilabert, M. and Piana, G. (2014) How to Define Transarterial Chemoembolization Failure or Refractoriness: A European Perspective. Liver Cancer, 3, 119-124. [Google Scholar] [CrossRef] [PubMed]
[11] Zhong, B., Wang, W., Zhang, S., Zhu, H., Zhang, L., Shen, J., et al. (2021) Re-Evaluating Transarterial Chemoembolization Failure/Refractoriness: A Survey by Chinese College of Interventionalists. Journal of Clinical and Translational Hepatology, 9, 521-527. [Google Scholar] [CrossRef] [PubMed]
[12] Iwasa, S., Ikeda, M., Okusaka, T., Ueno, H., Morizane, C., Nakachi, K., et al. (2011) Transcatheter Arterial Infusion Chemotherapy with a Fine-Powder Formulation of Cisplatin for Advanced Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization. Japanese Journal of Clinical Oncology, 41, 770-775. [Google Scholar] [CrossRef] [PubMed]
[13] Ikeda, M., Mitsunaga, S., Shimizu, S., Ohno, I., Takahashi, H., Okuyama, H., et al. (2013) Efficacy of Sorafenib in Patients with Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization. Journal of Gastroenterology, 49, 932-940. [Google Scholar] [CrossRef] [PubMed]
[14] Hatooka, M., Kawaoka, T., Aikata, H., et al. (2016) Comparison of Outcome of Hepatic Arterial Infusion Chemotherapy and Sorafenib in Patients with Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization. Anti-cancer Research, 36, 3523-3529.
[15] Kirikoshi, H. (2012) Is Hepatic Arterial Infusion Chemotherapy Effective Treatment for Advanced Hepatocellular Carcinoma Resistant to Transarterial Chemoembolization? World Journal of Gastroenterology, 18, 1933-1939. [Google Scholar] [CrossRef] [PubMed]
[16] Kodama, K., Kawaoka, T., Aikata, H., Uchikawa, S., Inagaki, Y., Hatooka, M., et al. (2018) Comparison of Clinical Outcome of Hepatic Arterial Infusion Chemotherapy and Sorafenib for Advanced Hepatocellular Carcinoma According to Macrovascular Invasion and Transcatheter Arterial Chemoembolization Refractory Status. Journal of Gastroenterology and Hepatology, 33, 1780-1786. [Google Scholar] [CrossRef] [PubMed]
[17] Li, Q., He, M., Chen, H., Fang, W., Zhou, Y., Xu, L., et al. (2022) Hepatic Arterial Infusion of Oxaliplatin, Fluorouracil, and Leucovorin versus Transarterial Chemoembolization for Large Hepatocellular Carcinoma: A Randomized Phase III Trial. Journal of Clinical Oncology, 40, 150-160. [Google Scholar] [CrossRef] [PubMed]
[18] 中国抗癌协会肝癌专业委员会. 肝动脉灌注化疗治疗肝细胞癌中国专家共识(2021版) [J]. 中华消化外科杂志, 2021, 20(7): 754-9.
[19] Xie, D., Zhu, K., Ren, Z., Zhou, J., Fan, J. and Gao, Q. (2023) A Review of 2022 Chinese Clinical Guidelines on the Management of Hepatocellular Carcinoma: Updates and Insights. Hepatobiliary Surgery and Nutrition, 12, 216-228. [Google Scholar] [CrossRef] [PubMed]
[20] Hsu, S., Xu, X., Chen, M., Zhao, Z., Wang, Y., Yin, X., et al. (2021) Hepatic Arterial Infusion Chemotherapy with Modified FOLFOX as an Alternative Treatment Option in Advanced Hepatocellular Carcinoma Patients with Failed or Unsuitability for Transarterial Chemoembolization. Academic Radiology, 28, S157-S166. [Google Scholar] [CrossRef] [PubMed]
[21] Wu, Y., Zheng, S., Zhang, Z., Chen, G., Chen, X., Zheng, T., et al. (2022) Hepatic Arterial Infusion Chemotherapy with Oxaliplatin Plus Raltitrexed as an Alternative Option in Advanced Hepatocellular Carcinoma Patients with Failure of, or Unsuitability for, Transarterial Chemoembolization. Medicina, 58, Article 1343. [Google Scholar] [CrossRef] [PubMed]
[22] Hien, P.N., Chun, H.J., Oh, J.S., Kim, S.H. and Choi, B.G. (2024) Hepatic Arterial Infusion Chemotherapy for Hepatocellular Carcinoma Refractory to Transarterial Chemoembolization: Exploring the Influence of Prior Transarterial Chemoembolization and Additional Transarterial Chemoembolization on Survival Outcomes. Journal of Gastrointestinal Oncology, 15, 721-729. [Google Scholar] [CrossRef] [PubMed]
[23] Lin, L., Ke, K., Yan, L., Chen, R. and Huang, J. (2023) Efficacy and Safety of Hepatic Artery Infusion Chemotherapy Combined with Tyrosine Kinase Inhibitors Plus Programmed Death-1 Inhibitors for Hepatocellular Carcinoma Refractory to Transarterial Chemoembolization. Frontiers in Oncology, 13, Article 1178428. [Google Scholar] [CrossRef] [PubMed]
[24] Diao, L., Wang, C., You, R., Leng, B., Yu, Z., Xu, Q., et al. (2024) Hepatic Arterial Infusion Chemotherapy Combined with Lenvatinib and PD‐1 Inhibitors versus Lenvatinib and PD‐1 Inhibitors for HCC Refractory to TACE. Journal of Gastroenterology and Hepatology, 39, 746-753. [Google Scholar] [CrossRef] [PubMed]

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