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Preventive treatments for recurrence after curative resection of hepatocellular carcinoma - A literature review of randomized control trials

机译：肝癌根治性切除术后复发的预防性治疗-随机对照试验文献综述

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摘要

To review the inhibitory effect of preventive approaches on recurrence after operation in patients with hepatocellular carcinoma (HCC), we summarized all available publications reporting randomized control trial indexed in PubMed. The treatment approaches presented above included pre-operative transcatheter arterial chemoembolization (TACE), post-operative TACE, systemic or locoregional chemotherapy, immunotherapy, Interferons and acyclic retinoic acid. Although no standard treatment has been established, several approaches presented promising results, which were both effective and tolerable in post-operative patients. Pre-operative TACE was not effective on prolonging survivals, while post-operative TACE was shown with both disease-free survival and overall survival benefits in some papers, however, it was also questioned by others. Systemic chemotherapy was generally not effective on prolonging survival but also poorly tolerated for its significant toxicities. Adoptive immunotherapy using LAK cells was proved to be beneficial to patients' survival in a recent paper. Interferon α and Interferon β can inhibit recurrence in HCC patients with HCV infection background, though the mechanism is not fully understood. Acyclic retinoic acid was shown to decrease multi-centric recurrence after operation, which was reported by only one group. In conclusion, several adjuvant approaches have been studied for their efficacy on recurrence in HCC patients in randomized control trials; however, multi-centric randomized control trial is still needed for further evaluation on their efficacy and systemic or local toxicities; in addition, new adjuvant treatment should be investigated to provide more effective and tolerable methods for the patients with HCC after operation.
机译：为了回顾预防方法对肝细胞癌（HCC）患者术后复发的抑制作用，我们总结了所有发表在PubMed中的随机对照试验报告。以上介绍的治疗方法包括术前经导管动脉化疗栓塞（TACE），术后TACE，全身或局部区域化疗，免疫疗法，干扰素和无环视黄酸。尽管尚未建立标准治疗方法，但几种方法均显示出令人鼓舞的结果，这些结果对术后患者均有效且可耐受。术前TACE对延长生存期无效，而在一些论文中表明术后TACE具有无病生存期和总体生存期优势，但是，也有人对此提出质疑。全身化疗通常不能有效延长生存期，但由于其明显的毒性而耐受性差。最近的一篇论文证明使用LAK细胞的过继免疫疗法对患者的生存有益。干扰素α和干扰素β可以抑制患有HCV感染背景的HCC患者的复发，尽管其机理尚不完全清楚。无环视黄酸显示减少手术后多中心复发，只有一组报道。总之，在随机对照试验中，已经研究了几种辅助方法对HCC患者复发的疗效。但是，仍然需要进行多中心随机对照试验，以进一步评估其疗效以及全身或局部毒性。此外，应研究新的辅助治疗方法，为肝癌术后患者提供更有效，更耐受的方法。

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  • 来源
    《World Journal of Gastroenterology》 |2003年第4期|p.635-640|共6页
  • 作者

    Hui-Chuan Sun; Zhao-You Tang;

  • 作者单位

    Surgery, Liver Cancer Institute and Zhong Shan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai 200032, China;

  • 收录信息 美国《科学引文索引》(SCI);美国《工程索引》(EI);美国《生物学医学文摘》(MEDLINE);美国《化学文摘》(CA);
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 消化系及腹部疾病;
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