Background/Objective: Hepatocellular carcinoma (HCC) is an aggressive disease that is known to be resistant to conventional chemotherapy and radiotherapy. While surgical resection and transarterial therapy can improve overall survival, the biological aspects of HCC contribute to the complexity of its management and limit the effectiveness of current treatment options. The purpose of this scoping review is to identify the limitations of the currently available therapies for HCC and explore the emerging role that histotripsy could play in addressing these limitations, with the intent of informing the direction of future research and clinical management. Methods: The PRISMA checklist for scoping reviews was followed to structure this review, and a systematic search was conducted in the following online databases: PubMed/MEDLINE (National Library of Medicine), Embase (Elsevier), and Scopus (Elsevier). Results: The current evidence supports that histotripsy offers several key advantages that address the limitations of the current treatment strategies for HCC. Clinical trials have highlighted the ability of this technology to destroy solid tumors and induce remission with minimal side effects. In addition, current preclinical studies point to the potent immunostimulatory effects of histotripsy, including the induction of abscopal effects. This poses significant promise in treating tumor metastasis as well as improving clinical regimens by combining histotripsy with immunotherapy. Future research should aim to overcome the current limitations of histotripsy and enhance clinical outcomes for patients. This review examines existing treatments for HCC, emphasizing the promising potential of combining histotripsy with immunotherapy to target the metastatic and advanced stages of the disease.
背景/目的：肝细胞癌（HCC）是一种侵袭性疾病，已知对传统化疗和放疗具有耐药性。虽然手术切除和经动脉治疗可以提高总体生存率，但HCC的生物学特性导致其治疗管理复杂化，并限制了现有治疗方案的疗效。本范围综述旨在明确当前HCC治疗方法的局限性，并探讨组织粉碎术在应对这些局限性方面可能发挥的新兴作用，以期指导未来研究和临床管理的方向。 方法：本综述遵循PRISMA范围综述清单构建框架，并在以下在线数据库中进行了系统性检索：PubMed/MEDLINE（美国国家医学图书馆）、Embase（Elsevier）和Scopus（Elsevier）。 结果：现有证据表明，组织粉碎术具有多项关键优势，能够针对当前HCC治疗策略的局限性发挥作用。临床试验证实该技术能够消融实体肿瘤并诱导缓解，且副作用极小。此外，当前临床前研究指出组织粉碎术具有强大的免疫刺激效应，包括诱导远端效应。这为治疗肿瘤转移以及通过组织粉碎术联合免疫疗法优化临床方案带来了重要前景。未来研究应致力于克服组织粉碎术当前的技术局限，提升患者临床疗效。本综述系统考察了HCC的现有治疗方法，重点探讨了组织粉碎术联合免疫疗法靶向治疗转移性和晚期疾病的巨大潜力。
The Emerging Role of Histotripsy in Liver Cancer Treatment: A Scoping Review
肿瘤(癌症)患者之家