Hepatocellular carcinoma (HCC) accounts for 90% of liver cancer cases worldwide and is currently the most quickly increasing cause of cancer-related deaths in the United States. The 5-year survival rate for primary liver cancer is estimated to be below 20%, and HCC mortality is expected to increase by 41% by 2040. Currently, surgical resection is the first-line approach to definitive treatment of early-stage HCC. However, the majority of patients present with late-stage, unresectable disease due to the asymptomatic nature of early HCC. For patients who present with unresectable HCC, locoregional therapies such as transarterial chemoembolization (TACE) represent an alternative approach to HCC treatment. TACE is a minimally invasive, catheter-based technique that allows for targeted delivery of chemotherapy to tumor sites while occluding tumor-feeding blood vessels. In appropriately selected patients, outcomes for TACE therapy have been shown to be more favorable than supportive care or conservative management. The increasing incidence and mortality of HCC, in addition to the late-stage presentation of most HCC patients, demonstrates the need to expand the role of locoregional therapies in the treatment of HCC. TACE represents an appealing approach to HCC management, including disease control, palliation, and potentially curative-intent strategies. In this review, we will describe the current utility of TACE in the treatment of HCC, characterize the outcomes of patients treated with TACE across different HCC stages, and outline future applications of TACE in the treatment paradigm.
肝细胞癌（HCC）占全球肝癌病例的90%，目前是美国癌症相关死亡增长最快的病因。原发性肝癌的五年生存率预计低于20%，且到2040年HCC死亡率预计将增长41%。目前，手术切除是早期HCC根治性治疗的一线方案。然而，由于早期HCC无明显症状，大多数患者确诊时已处于晚期不可切除阶段。对于不可切除的HCC患者，经动脉化疗栓塞术（TACE）等局部区域疗法成为替代治疗方案。TACE是一种基于导管操作的微创技术，可在栓塞肿瘤供血血管的同时实现化疗药物的靶向递送。对于经过恰当筛选的患者，TACE治疗的疗效已被证实优于支持性治疗或保守治疗。HCC发病率和死亡率的持续上升，加之多数患者确诊时已处于晚期，凸显了扩大局部区域疗法在HCC治疗中应用的必要性。TACE作为一种具有前景的HCC治疗策略，在疾病控制、姑息治疗乃至潜在根治性治疗方面均展现出应用价值。本综述将阐述TACE在HCC治疗中的当前应用现状，分析不同分期HCC患者接受TACE治疗的疗效特征，并展望TACE在未来治疗模式中的应用前景。
Transarterial Chemoembolization Treatment Paradigms for Hepatocellular Carcinoma
肿瘤(癌症)患者之家