臨床藥物治療學(xué)原發(fā)性肝癌-資料下載頁(yè)
2025-01-05 14:46本頁(yè)面
【正文】 , liver function and physical impact of treatment should also be considered when estimating life expectancy. Currently, the BCLC system is the only staging system that acplishes these aims (level II2).BarcelonaClinic LiverCancer (BCLC) staging system Remendation 12－ 1312. Patients who have a single lesion can be offered surgical resection if they are noncirrhotic or have cirrhosis but still have well preserved liver function,normal bilirubin and hepatic vein pressure gradient10 mmHg (level II).12）對(duì)于非肝硬化或是肝硬化但仍很好保存肝功能，正常的膽紅素和肝門(mén)靜脈壓力梯度小于10mmHg的單個(gè)腫瘤的患者可以行外科切除。 （ II級(jí)） 13. Pre or postresection adjuvant therapy is notremended (level II) 13）不推薦在腫瘤切除前或后加用其它輔助治療。（ II級(jí)）Remendation 1414）按照米蘭標(biāo)準(zhǔn)：?jiǎn)蝹€(gè)腫瘤小于 5cm或者不超過(guò) 3個(gè)結(jié)節(jié)小于3cm，對(duì)此類(lèi) HCC患者行肝移植是一個(gè)有效的方案。（ II級(jí)） 對(duì)如果等待的時(shí)間太長(zhǎng)，以至于腫瘤進(jìn)展被排除在等待移植之列的 HCC患者行活體移植。 （ II級(jí)）14. Liver transplantation is an effective option for patients with HCC corresponding to the Milan criteria:solitary tumor 5 cm or up to three nodules 3cm (level II). Living donor transplantation can be offered for HCC if the waiting time is long enough to allow tumor progression leading to exclusion from the waiting list (level II).Remendation15－ 17 15. No remendation can be made regardingexpanding the listing criteria beyond the standardMilan Criteria (level III). 15）不推薦對(duì)標(biāo)準(zhǔn)的等待肝移植的米蘭規(guī)則進(jìn)行擴(kuò)大。（ III級(jí)） 16. Preoperative therapy can be considered if the waiting list exceeds 6 months (level II). 16）如果等待肝移植的時(shí)間超過(guò) 6個(gè)月可以考慮進(jìn)行手術(shù)前治療。（ II級(jí)） 17. Local ablation is safe and effective therapy for patients who cannot undergo resection, or as a bridge to transplantation (level II). 17）對(duì)不能切除的患者或作為肝移植的橋梁，局部的消融治療是安全和有效的治療。 （ II級(jí)）Remendation 18 18. Alcohol injection and radiofrequency areequally effective for tumors 2 cm. However, thenecrotic effect of radiofrequency is more predictable in all tumor sizes and in addition, its efficacy is clearly superior to that of alcohol injection in larger tumors (level I).18）酒精注射和射頻治療對(duì)小于 2cm的腫瘤有同樣的效果。 但是射頻治療對(duì)所有大小的腫瘤的壞死效果更可以預(yù)期，而且對(duì)于大的腫瘤射頻治療的效果明顯優(yōu)于酒精注射治療。（ I級(jí)）Remendation 19 19. TACE is remended as first line noncurative therapy for nonsurgical patients with large/multifocal HCC who do not have vascular invasion or extrahepatic spread (level I). 19）對(duì)于沒(méi)有血管侵犯或肝外轉(zhuǎn)移的大或多灶的不能外科治療的患者，建議將 TACE作為一線非治愈性治療方法。（ I級(jí)）Remendation20 20. Tamoxifen, antiandrogens, octreotide or hepatic artery ligation/embolization are not remended (level I). Other options such as radiolabelled Yttrium glass beads, radiolabelled lipiodol or immunotherapy cannot be remended as standard therapy for advanced HCC outside clinical trials. 20）不推薦予以三苯氧胺 ，抗雄激素藥物，善得定或肝動(dòng)脈結(jié)扎術(shù)或栓塞術(shù)等治療。（ I級(jí)）對(duì)晚期HCC患者，超出臨床試驗(yàn)范圍的不推薦行其它一些如含放射標(biāo)記的釔的玻璃球，含放射標(biāo)記的碘化油注射或免疫治療。Remendation 2121. Systemic or selective intraarterial chemotherapy is not remended and should not be used as standard of care (level II). 21）不推薦行全身或選擇性動(dòng)脈內(nèi)化療 ,也不應(yīng)作為標(biāo)準(zhǔn)治療方案。 （ II級(jí)）? Thanks 謝謝觀看 /歡迎下載BY FAITH I MEAN A VISION OF GOOD ONE CHERISHES AND THE ENTHUSIASM THAT PUSHES ONE TO SEEK ITS FULFILLMENT REGARDLESS OF OBSTACLES. BY FAITH I BY FAI
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