Liver cancer, which is a liver malignant tumor, can be divided into two major categories: primary and secondary. Primary hepatic malignancies originate from epithelial or mesenchymal tissues of the liver. The former is called primary liver cancer. It is a malignant tumor which is highly harmful to China. The latter is called sarcoma, which is relatively rare compared with primary liver cancer. Secondary or metastatic hepatocellular carcinoma (HCC) refers to the invasion of a malignant tumor of multiple organ origin to the liver. Commonly seen in the stomach, the bile duct, the pancreas, the colorectal, ovary, uterus, lung, breast and other organs of malignant tumor liver metastasis.
According to the different stages of liver cancer, individualized comprehensive treatment is the key to improve the curative effect. The treatment includes surgery, hepatic artery ligation, transcatheter arterial chemoembolization, radiofrequency, freezing, laser, microwave, chemotherapy and radiotherapy. Biological treatment, traditional Chinese medicine for the treatment of liver cancer is also a lot of application.
Surgical treatment of 1.
Surgery is the first choice for the treatment of liver cancer, and it is also the most effective method. The surgical methods were radical hepatectomy, palliative hepatectomy and so on.
For unresectable hepatocellular carcinoma, intraoperative hepatic artery ligation, transcatheter arterial chemoembolization, radiofrequency, cryopreservation, laser and microwave therapy are effective according to specific circumstances. Primary liver cancer is also one of the indications of liver transplantation.
2. chemical therapy
After laparotomy revealed unresectable cancer as a tumor, or palliative resection and follow-up treatment, the hepatic artery and portal vein (or) pump (subcutaneous infusion device) for regional chemotherapy embolization; estimation of unresectable, feasible interventional radiology, selective intubation to hepatic artery via femoral artery. Embolic agent (commonly used as anticancer drugs and lipiodol) chemotherapy embolism, some patients can therefore get surgery opportunity.
3. radiation therapy
Good on the general situation, liver function is good, not associated with liver cirrhosis, jaundice, ascites, hypersplenism and esophageal varices, cancer is limited, no distant metastasis and not suitable for surgical resection or recurrence after surgery, comprehensive treatment can be dominated by radio.
4. biological therapy
It is commonly used as immunribonucleic acid, interferon, interleukin -2, thymosin and so on, which can be used in combination with chemotherapy.
5. treatment of traditional Chinese Medicine
Take the method of syndrome differentiation, supplementation and attack, often associated with other therapy combined with application. In order to improve the body's resistance to disease, improve the condition and symptoms of the whole body, and reduce the adverse reaction of chemotherapy and radiotherapy.
6. targeted drug
Sorafenib only targeted drugs have been successfully listed
So far, Sola Fini is still the only molecular targeted therapy for advanced hepatocellular carcinoma without operation and distant metastasis. It has been listed in Europe, the United States and China. Phase III clinical trials showed that Sola Fini's advanced liver cancer could prolong the patient's survival. Other molecular targeted drugs, such as cancer cells, epidermal growth factor receptor and erlotinib for tumor angiogenesis of vascular endothelial growth factor VEGF monoclonal antibody has entered phase II clinical trials, preliminary results also show that the effective on liver cancer. However, the signal transduction of tumor cells is a complex network system. For single target, it is often not enough to contain tumor. Multiple target therapies combined with different pathways and mechanisms are needed. For example, sorafenib combined with antiangiogenic drugs (bevacizumab, recombinant human endostatin and thalidomide) or EGFR inhibitor (cetuximab and nimotuzumab), or Sola Fini combined with chemotherapy drugs (5-fluorouracil, tegafur, capecitabine, oxaliplatin plus gemcitabine and oxaliplatin plus capecitabine) the treatment of advanced hepatocellular carcinoma. But the best usage, dosage, and course of treatment need to be clarified by a standardized clinical study.
7. Immune preparation
PD-1 inhibitor
In December 22, 2014, Bristol Myers Opdivo officially listed in the United States
In the 2016 annual meeting of the digestive tract tumor, BMS update PD-1 inhibitor Opdivo for advanced hepatocellular carcinoma: a data in participation by 214 patients in clinical trials, single drug Opdivo can make a decrease of at least 30% of 43 patients (20% tumor objective efficiency than the premise of high!) The tumors of the other 64 patients could be stabilized without progress, the rate of disease control was up to 64%, the 9 month survival rate was 74%, and the proportion of the 3-4 side effects was 20%. Opdivo is safe and well tolerated, even in patients infected with HBV and HCV. If chemotherapy fails, liver cancer patients fail to achieve targeted drug treatment, disease continues to progress, and their own economic situation is not bad. We can consider PD-1 monoclonal antibody therapy.
