CSCO2021丨对话赵明教授:介入联合系统治疗优选方案,助力肝癌转化治疗“升级打怪”

作者:肿瘤瞭望   日期:2021/9/27 11:06:20  浏览量:26514

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我国有近七成的初诊肝癌患者为不可手术切除的中晚期肝癌,整体的5年生存率较低、预后较差。近年来,不断发展的介入治疗、靶向治疗为中晚期肝癌患者提供了转化治疗的手段,也进一步拓展了肝癌转化治疗的内涵。

 
 
赵明教授:提高我国肝癌患者的5年生存率,首先是要强调“早诊早治”。我们知道日本的肝癌5年生存率已达到60%,远远高于我国的14%,其最主要的原因是他们的肝癌早筛水平很高。实际上,日本有的肝癌治疗技术,我们也已经有了。但我国的肝癌筛查还不够,而且存在较大的地区差异。由于早期肝癌的5年生存率可以达到70%以上,小肝癌甚至可达90%以上,所以提高早诊早治水平,是提高我国肝癌整体生存率的关键所在。
 
再者,我们要强调提高肝癌的规范化诊疗水平。随着肝癌诊疗技术的进步,我们现在有了介入、消融、手术等局部治疗,还有化疗、靶向、免疫等众多系统治疗,不同分期的肝癌患者,需要不同学科的参与。在多学科协作(MDT)模式下,可以为患者提供更加个体化的最佳治疗决策。
 
最后,我们要继续不断创新。其实不同治疗手段都有其优势和局限性,外科、介入医生也要掌握药物治疗的相关机制,才能更好地将局部治疗与系统治疗联合。比如今年Kudo教授发表的一项如何减少肝癌术后复发的研究,对于病理检测T细胞富集的肿瘤,术后给予免疫治疗可以减少复发,对于富含MDSC等免疫抑制细胞的肿瘤,术后免疫治疗的效果很差。
 
希望通过大家的努力,能够进一步推动肝癌诊疗技术的发展,让更多肝癌患者获得及时、规范的治疗,从而改善患者预后,早日实现“健康中国2030”的伟大蓝图。
 
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