https://scholars.lib.ntu.edu.tw/handle/123456789/580404
標題: | Recent advances in non-surgical treatment for advanced hepatocellular carcinoma | 作者: | CHIUN HSU CHIA-HSIEN CHENG ANN-LII CHENG |
公開日期: | 2004 | 卷: | 103 | 期: | 7 | 起(迄)頁: | 483-495 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Hepatocellular carcinoma (HCC) is one of the most common cancers and is the leading cause of cancer death in Taiwan. Curative surgery is feasible for only about 30% of patients. Transarterial embolization or chemoembolization (TAE/TACE) has been demonstrated to provide a survival benefit compared with supportive care for HCC patients with adequate liver reserves, tumors confined to the liver, and no evidence of portal vein thrombosis. Percutaneous ethanol injection (PEI) may provide long-term disease control if the extent of liver tumors is limited (3 or less in number and less than 3 cm in diameter). The relative efficacy of TAE/TACE, PEI, and other locoregional treatment modalities, such as radiofrequency ablation or cryosurgery, remains unclear. Radiotherapy has been used mostly as a salvage therapy in combination with other locoregional modalities. Despite the incorporation of 3-dimensional conformal technology, radiation-induced liver injury remains an important problem, especially for patients with hepatitis B-related cirrhosis. Systemic therapy is difficult for HCC because of the underlying cirrhosis and accompanying hypersplenism and peripheral cytopenia. HCC is typically resistant to most cytotoxic agents. Biochemical modulation with high-dose tamoxifen may sensitize HCC cells to doxorubicin-induced apoptosis and improve the clinical response to doxorubicin in patients with advanced HCC. Thalidomide, which inhibits angiogenesis induced by vascular endothelial growth factor and basic fibroblast growth factor, can produce a response in some HCC patients. Future research on drug therapy for HCC will focus on identification of tumor-specific targets. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-6344235699&partnerID=40&md5=b346759ed726c698dd459775cbd4adae https://scholars.lib.ntu.edu.tw/handle/123456789/580404 |
ISSN: | 0929-6646 | SDG/關鍵字: | alcohol; alpha interferon; angiogenesis inhibitor; antineoplastic agent; capecitabine; cisplatin; cytotoxic agent; doxorubicin; epidermal growth factor receptor; epidermal growth factor receptor 2; etoposide; fluorouracil; folinic acid; gemcitabine; imatinib; iodinated poppyseed oil; iridium 192; irinotecan; octreotide; oxaliplatin; paclitaxel; placebo; rituximab; tamoxifen; thalidomide; topotecan; trastuzumab; UFT; unindexed drug; yttrium 90; advanced cancer; antineoplastic activity; apoptosis; artificial embolism; blood toxicity; bone marrow suppression; brachytherapy; cancer control; cancer inhibition; cancer resistance; cancer survival; catheter ablation; chemoembolization; clinical trial; conservative treatment; constipation; cryosurgery; cytopenia; dizziness; dose response; drug efficacy; drug eruption; drug megadose; drug sensitization; drug targeting; human; hypersplenism; lethargy; liver cell carcinoma; liver cirrhosis; liver failure; liver injury; meta analysis; multimodality cancer therapy; phototherapy; radiation response; review; salvage therapy; systemic disease; systemic therapy; tumor vascularization; tumor volume; Carcinoma, Hepatocellular; Catheter Ablation; Embolization, Therapeutic; Humans; Liver Neoplasms; Neovascularization, Pathologic |
顯示於: | 醫學系 |
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