Recently, the use of Yttrium-90 transarterial radioembolization in non-surgical hepatocellular carcinoma was suggested but the evidence supporting its use is unclear.
最近,有人建议使用钇-90经动脉放射栓塞治疗非手术性肝细胞癌,但支持其使用的证据尚不清楚。
Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths in the world, resulting in approximately 800,000 deaths globally annually [1].
肝细胞癌(HCC)是世界上第四大癌症相关死亡原因,每年导致全球约80万人死亡。
It is typically diagnosed late in its course and the median survival following diagnosis ranges from 6 to 20 months [2].
它通常在病程晚期才被诊断,诊断后的中位生存期为6-20个月]。
At diagnosis, approximately only 30% of patients are eligible for curative treatments including surgery, mostly owing to extent of disease and patient comorbidities, including cirrhosis [2].
在诊断时,大约只有30%的患者有资格接受包括手术在内的治疗,主要是由于疾病的分期程度和患者的共患疾病,其中肝硬化是主要原因]。
According to the Barcelona Clinic Liver Cancer (BCLC) staging system and guidelines, the standard treatment for intermediate HCC (BCLC stage B) is either conventional or drug-eluting beads transarterial chemoembolization (TACE) [3].
根据巴塞罗那诊所肝癌(BCLC)分期系统和指南,中期HCC(BCLC-B期)是标准TACE或载药微球TACE的标准治疗方法
For advanced HCC (BCLC stage C), sorafenib recently became standard treatment after two trials documented benefits in overall survival (OS)
对于晚期HCC(BCLCC期),索拉非尼最近在两项试验证明了总生存期(OS)的获益后成为了标准治疗方法。
However, although new treatments are available, the survival benefit is still not optimal and new alternatives are sought.
然而,尽管有新的治疗方法可用,但生存益处仍然不是最佳的,而且正在寻找新的替代方案。
More recently, Y90-TARE was developed for the treatment of HCC and offers inherent advantages such as outpatient setting during a single treatment session
最近,Y90-TARE被开发用于治疗HCC,并提供了固有的优势,如在单一治疗阶段情况下的门诊治疗。
However, despite significant amount of promising results derived from retrospective data , its use remains limited due to the uncertainty on its efficacy.
然而,尽管从回顾性数据[8,9]中获得了大量有希望的结果,但由于其疗效的不确定性,其使用仍然有限。
Consequently, Y90-TARE is not considered a first-line treatment for HCC in recent guidelines .
因此,在最近的指南中,Y90-TARE并不被认为是HCC的一线治疗方法。
However, Y90-TARE is offered to patients from early to terminal BCLC stage in monotherapy or in combination.
然而,Y90-TARE不管单药治疗或联合治疗,从早期至晚期期患者都可以考虑。
Considering the potential benefit of Y90-TARE and the limited evidence supporting its use, we conducted a systematic review and meta-analysis to assess the efficacy and safety of Y90-TARE in non-surgical HCC patients.
考虑到Y90-TARE的潜在益处和支持其使用的有限证据,我们进行了系统回顾和荟萃分析,以评估Y90-TARE在非手术HCC患者中的有效性和安全性。
对于不可切除的肝癌,至目前为止是三线治疗? 由于TARE快速进展,Cochrane撤销了2016年首次发表的关于不可切除肝癌钇90的综述,准备添加4个新的临床试验。Cochrane在生命中说,在之前发表的综述版本中,我们得出结论,与未治疗、假放射栓塞或其他全身或局部治疗相比,证据不足以评估钇-90微球放射栓塞对肝细胞癌患者的有益和有害影响。在更新的审查版本中,我们之前的结论添加了:.与索拉非尼相比,放射栓塞似乎达到了同等的生存率,而且副作用更小,但我们的确定性低到非常低,一般的来说,更好地制定了我们的结论 |