Hepatocellular carcinoma (HCC) represents an entity of poor prognosis, especially in cases of delayed diagnosis. According to the Barcelona Clinic Liver Cancer (BCLC) staging system, patients in BCLC-A are the most suitable for potentially curative treatments (surgery or radiofrequency ablation), whereas those in BCLC-C should be treated only with systemic treatment, as locoregional interventions are ineffective due to the tumor’s extensiveness. For patients in the BCLC-B stage, trans-arterial chemoembolization (TACE) is the reference treatment, but the role of systemic treatment has been constantly increasing. As this group of patients is extremely heterogeneous, a case-by-case therapeutic strategy instead of a one-fits-all treatment is certainly required to achieve adequate results against HCC. The decision of selecting among immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs), TACE, or a combination of them depends on the patient’s tumor load, the severity of liver dysfunction, the general performance status, and the presence of concomitant extrahepatic diseases. The objective of this review is to critically appraise the recent data regarding the systemic treatment of BCLC-B HCCs, aiming to emphasize its potential role in the management of these difficult-to-treat patients.
肝细胞癌（HCC）预后较差，尤其在诊断延迟的情况下。根据巴塞罗那临床肝癌（BCLC）分期系统，BCLC-A期患者最适合接受潜在根治性治疗（手术或射频消融），而BCLC-C期患者因肿瘤范围广泛，局部治疗无效，仅应接受全身治疗。对于BCLC-B期患者，经动脉化疗栓塞（TACE）是标准治疗方案，但全身治疗的作用正日益凸显。由于该患者群体具有高度异质性，为取得理想的肝癌治疗效果，必须采取个体化治疗策略而非“一刀切”方案。选择免疫检查点抑制剂（ICIs）、酪氨酸激酶抑制剂（TKIs）、TACE或其联合方案，需综合考虑患者的肿瘤负荷、肝功能障碍严重程度、全身功能状态以及是否合并肝外疾病。本综述旨在系统评述近期关于BCLC-B期肝细胞癌全身治疗的研究数据，以强调其在治疗这类难治性患者中的潜在作用。
Systemic Treatment in Intermediate Stage (Barcelona Clinic Liver Cancer-B) Hepatocellular Carcinoma
肿瘤(癌症)患者之家