摘要
肝细胞癌为常见肿瘤,死亡率高,生存期短,多数患者就诊时已进入晚期,不适宜手术切除。尽管局部治疗如肝动脉栓塞化疗被证明有效,但相当多的晚期患者并不适合。本文对目前已有的肝癌全身治疗的Ⅱ和Ⅲ期临床试验进行总结,化疗、激素治疗或是免疫治疗方案还没有一种能够确定地延长病人的生存时间。且多数实验纳入病例数目少,入选者存在明显的选择偏倚。因此,目前晚期肝癌的全身治疗仍属于临床实验性质。但另一方面,其他治疗,包括传统中医药,以及针对EGFR、Mcl-1、COX-2信号传导途径的生物靶向治疗,还有基因治疗(如通过RNA干涉)都在肝癌治疗的体外实验和体内试验中显示出良好前景。
Hepatocellular carcinoma （HCC） is a common cause of cancer mortality worldwide.Whilst local treatments are useful in selected patients, they are not suitable for many with advanced disease. Here, we review phase Ⅱ and Ⅲ trials for systemic therapy of advanced disease, finding no strong evidence that any chemotherapy, hormonal therapy, or immunotherapy regimen trialled to date benefits survival in this setting. Many trials were inadequately powered, single centre, and enrolled highly selected patients. From this review, we cannot recommend any therapeutic approach in these patients outside of a clinical trial setting. However, other therapies including the traditional Chinese medicine and biological treatment aiming at targets such as EGFR, Mcl - 1, COX2 signal conduction pathway as well as the genetic treatment through RNAi has shown promising perspective in both in vivo and in vitro studies of hepatic carcinoma.
出处
《癌症进展》
2007年第1期79-84,共6页
Oncology Progress
