中晚期原发性肝癌的降期转化治疗

Downstaging conversion therapy for advanced primary liver cancer

中国大多数原发性肝癌患者初诊时已是中晚期,丧失手术治疗机会,因此,如何将中晚期肝癌降期为可手术切除的肝癌是近年临床研究热点。而能否转化成功的关键前提是,通过充分的检查评估和必要的多学科诊疗讨论筛选出适合转化的人群或可能转化成功的人群。分别介绍了因肺转移、门静脉癌栓、巨块型肿瘤播散或多发肿瘤的肝癌,肝功能失代偿的肝癌,已发生肝癌播散转移且ECOG体质评分>2的肝癌以及HBV高载量肝癌的转化策略与转化后的抗肿瘤治疗策略,对临床中晚期肝癌患者的降期转化治疗具有一定的指导意义。

Most patients with primary liver cancer in China are in the advanced stage at initial diagnosis and lose the opportunity for surgical treatment, and therefore, how to reduce advanced liver cancer to resectable liver cancer is a hot topic in clinical research in recent years. The key premise of successful conversion is to screen out the individuals who are suitable for conversion or may achieve successful conversion through comprehensive examination and necessary multidisciplinary consultation. This article introduces the conversion strategy and the antitumor strategy for liver cancer with lung metastasis, portal vein tumor thrombus, massive tumor dissemination, or multiple tumors, liver cancer with liver function decompensation, liver cancer with liver cancer dissemination and metastasis and an ECOG constitution score of >2, and liver cancer with a high HBV load, which has certain guiding significance in the downstaging conversion therapy for advanced liver cancer in clinical practice.