中晚期肝细胞癌介入治疗的现状与进展

摘要

肝细胞癌（HCC）是全球高发且高致死率的恶性肿瘤，多数患者确诊时已处于中晚期，难以获得根治性治疗。经动脉介入治疗作为中晚期HCC的重要治疗手段，主要包括经动脉化疗栓塞（TACE）、肝动脉灌注化疗（HAIC）及经动脉放射性栓塞（TARE）。TACE作为一线局部治疗，在新型载药微球、水凝胶及技术推动下不断优化；HAIC通过持续高浓度化疗药物灌注，尤其适用于高肿瘤负荷及门静脉侵犯患者；TARE在早期HCC患者中可实现接近手术切除的生存获益，对伴血管侵犯的中晚期患者同样具有良好的局部肿瘤控制效果。联合靶向治疗、免疫治疗及放疗、消融等策略进一步提高了介入治疗的疗效。新型药物递送系统、智能栓塞材料、抗反流导管、球囊辅助TACE及人工智能（AI）导航等技术不断发展，推动介入治疗向更精准、更安全及更具个体化的方向发展。本文系统阐述肝癌介入治疗的现状和进展，以期为临床实践和策略优化提供参考，改善患者预后。

关键词

肝细胞癌 / 经肝动脉化疗栓塞 / 经肝动脉放疗栓塞 / 经肝动脉灌注化疗 / 免疫治疗 / 靶向治疗

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基金资助

山东省自然科学基金项目(ZR2024QH349)