Chemotherapy for advanced hepatocellular carcinoma: systemic chemotherapy or hepatic arterial infusion chemotherapy?

摘要

Despite marked advances in the treatment of hepatocellular carcinoma such as hepatectomy, liver transplantation, percutaneous ethanol injection therapy, percutaneous radiofrequency ablation therapy, and transcatheter arterial embolization therapy, these therapies are frequently followed by repeated recurrence at local or other sites, leading to advanced cancer with portal vein invasion and distant or intrahepatic metastases. Although hepatocellular carcinoma is being increasingly detected in the early stage as a result of advances in various diagnostic imaging techniques, some patients are found to have advanced cancer because of the paucity of clinical symptoms. Most of these patients with advanced hepatocellular carcinoma frequently die from cancer progression rather than liver failure. For these patients, who are not considered eligible for surgery, percutaneous therapy, or embolization therapy, chemotherapy is frequently selected. To improve the prognosis of advanced hepatocellular carcinoma, more effective chemotherapy is needed; however, to date, no such chemotherapy has been established for advanced hepatocellular carcinoma.