HAIC是老技术还是新方法——理性看待肝动脉灌注化疗

Is HAIC an obsolete technology or a novel therapeutic method?HAIC should be treated rationally

中国是肝癌高发大国,患者约占世界总数的50%。经导管动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)是非手术治疗肝癌的一线方案。然而由于TACE的局限性和肝癌的异质性,治疗效果存在较大差异。近年来,肝动脉灌注化疗(hepatic artery infusion chemotherapy,HAIC)逐渐受到关注与重视,有研究得出在适合TACE治疗范围内的中晚期肝癌人群中,HAIC的疗效优于TACE的结论。为此,本文回顾了HAIC和TACE治疗的历史,以及其分别在肝癌治疗中的作用与地位,我国目前在HAIC治疗中所存在的弊端等;此外,对TACE治疗肝癌所存在的一些争议以及操作规范化等问题进行了阐述,以期推进肝癌局部治疗的规范化,提高肝癌介入治疗的效果。

The incidence of hepatocellular carcinoma(HCC)in China is very high,it accounts for about 50%of the total number of patients in the world.Transcatheter arterial chemoembolization(TACE)has been a first-line regimen for the nonsurgical treatment of HCC.However,due to the limitations of TACE and the heterogeneity of HCC,the efficacy of TACE varies greatly between the different patients.In recent years,hepatic artery infusion chemotherapy(HAIC)has attracted more and more attention in clinical practice,and some studies have indicated that HAIC is superior to TACE in treating intermediate-stage and advanced HCC patients who are suitable for TACE therapy.This paper aims to review the development history,clinical role and current status of HAIC and TACE in the treatment of HCC.The deficiencies and disadvantages existing in the clinical HAIC treatment in China are also discussed.Moreover,the dispute concerning TACE treatment for HCC and the operational standardization are elaborated,aiming to promote the standardization of local treatment of HCC and to improve the curative effect of interventional treatment for HCC.(J Intervent Radiol,2022,31:2-8)