肝癌实体瘤治疗疗效评价系统的研究进展

Research progress in evaluation systems of solid tumor response for malignant solid liver tumors

原发性肝癌(肝癌)是全球常见的恶性肿瘤之一,由于早期缺乏特异性的临床表现,大部分肝癌患者在确诊时就已处于中晚期,失去根治性手术的机会。中晚期肝癌常采用介入治疗和序贯靶向治疗以及免疫治疗等为主的综合性治疗。定期评估肿瘤的治疗疗效至关重要,既可以反映前期肿瘤治疗的有效性,又可以对后续的治疗提供指导作用。肝癌属于实体瘤,实体瘤的疗效评估系统从WHO标准、实体瘤治疗疗效评价标准(RECIST)等逐步发展至适合评估靶向治疗的mRECIST标准。随着肿瘤治疗模式的发展,传统评估体系在使用中暴露出许多问题,无法全面精准地评估肿瘤治疗疗效。因此亟须借助现有先进技术探索更全面精确的评估体系。本文将对肝癌等实体瘤的传统疗效评估体系进行综述。

Liver cancer is one of the most common malignant tumors worldwide.Due to lack of specific clinical manifestations during the early stage,most patients with liver cancer are diagnosed at middle and late stage,missing the opportunity of radical surgery.Interventional therapy,sequential targeted therapy,immunotherapy and other comprehensive therapies are mainly adopted for middle and late stage liver cancer.It is of significance to evaluate clinical efficacy on a regular basis,which can not only reflect the efficacy of preliminary treatment,but also provide guidance for subsequent treatment.Liver cancer belongs to solid tumor,and the evaluation systems of solid tumor response have gradually developed from WHO criteria,response evaluation criteria in solid tumours (RECIST) to modified RECIST (mRECIST) which is suitable for evaluating targeted therapy.With the development of tumor treatment regimen,multiple problems have been identified in the use of traditional evaluation system,which fail to comprehensively and accurately evaluate clinical efficacy of tumor treatment.Therefore,it is urgent to employ existing advanced technologies to establish a more comprehensive and accurate evaluation system.In this article,traditional evaluation systems of solid tumor response inlcuding liver cancer were reviewed.