实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (4): 636-640.doi: 10.3969/j.issn.1672-5069.2025.04.040
• 综述 • 上一篇
彭乐 综述, 黄古叶, 徐莉虹 审校
收稿日期:
2024-10-29
出版日期:
2025-07-10
发布日期:
2025-07-14
通讯作者:
黄古叶,E-mail:Huangguye@163.com
作者简介:
彭乐,男,25岁,硕士研究生,研究方向:肝胆系病证防治研究。E-mail:369346173@qq.com
Peng Le, Huang Guye, Xu Lihong
Received:
2024-10-29
Online:
2025-07-10
Published:
2025-07-14
摘要: 原发性肝癌(PLC)是世界上常见的主要癌症之一,也是恶性肿瘤死亡的第三大常见原因。肝动脉灌注化疗(HAIC)凭借出色的疗效和安全性,在治疗PLC领域获得了越来越多的使用。随着国内学者的积极探索,由奥沙利铂(OXA)和雷替曲塞组成的RALOX-HAIC方案在治疗方面疗效满意。本文就RALOX-HAIC及其联合治疗PLC的应用及前景进行了综述。
彭乐, 黄古叶, 徐莉虹. RALOX-HAIC在原发性肝癌发病机制中的作用研究进展[J]. 实用肝脏病杂志, 2025, 28(4): 636-640.
Peng Le, Huang Guye, Xu Lihong. Hepatic artery infusion chemotherapy based on oxaliplatin and raltitrexed in treatment of patients with primary liver cancer[J]. Journal of Practical Hepatology, 2025, 28(4): 636-640.
[1] Sung H, Ferlay J, Siegel R L, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021,71(3):209-249. [2] Rumgay H, Arnold M, Ferlay J, et al. Global burden of primary liver cancer in 2020 and predictions to 2040. J Hepatol, 2022,77(6):1598-1606. [3] Singal A G, Kanwal F, Llovet J M. Global trends in hepatocellular carcinoma epidemiology: implications for screening, prevention and therapy. Nat Rev Clin Oncol, 2023,20(12):864-884. [4] Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl), 2022,135(5):584-590. [5] Park J W, Chen M, Colombo M, et al. Global patterns of hepatocellular carcinoma management from diagnosis to death: the BRIDGE study. Liver Int, 2015,35(9):2155-2166. [6] Obi S, Sato S, Kawai T. Current status of hepatic arterial infusion chemotherapy. Liver Cancer, 2015,4(3):188-199. [7] Hohn D C, Stagg R J, Friedman M A, et al. A randomized trial of continuous intravenous versus hepatic intraarterial floxuridine in patients with colorectal cancer metastatic to the liver: the Northern California Oncology Group trial. J Clin Oncol, 1989,7(11):1646-1654. [8] Kemeny N, Daly J, Reichman B, et al. Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma. a randomized trial. Ann Intern Med, 1987,107(4):459-465. [9] Allen-Mersh T G,Earlam S,Fordy C,et al. Quality of life and survival with continuous hepatic-artery floxuridine infusion for colorectal liver metastases.Lancet, 1994,344(8932):1255-1260. [10] Toyoda H, Nakano S, Kumada T, et al. Clinical study of continuous local arterial-infusion chemotherapy for severely advanced hepatocellular carcinoma (HCC) using reservoir. Gan To Kagaku Ryoho, 1993,20(12):1769-1774. [11] Toyoda H, Nakano S, Kumada T, et al. The efficacy of continuous local arterial infusion of 5-fluorouracil and cisplatin through an implanted reservoir for severe advanced hepatocellular carcinoma. Oncology, 1995,52(4):295-299. [12] Raymond E, Faivre S, Chaney S, et al. Cellular and molecular pharmacology of oxaliplatin. Mol Cancer Ther, 2002,1(3):227-235. [13] Wang Z, Zhou J, Fan J, et al. Oxaliplatin induces apoptosis in hepatocellular carcinoma cells and inhibits tumor growth. Expert Opin Investig Drugs, 2009,18(11):1595-1604. [14] Petrelli F, Coinu A, Borgonovo K, et al. Oxaliplatin-based chemotherapy: a new option in advanced hepatocellular carcinoma. a systematic review and pooled analysis. Clin Oncol (R Coll Radiol), 2014,26(8):488-496. [15] Jackman A L, Taylor G A, Gibson W, et al. ICI D1694, a quinazoline antifolate thymidylate synthase inhibitor that is a potent inhibitor of L1210 tumor cell growth in vitro and in vivo: a new agent for clinical study. Cancer Res, 1991,51(20):5579-5586. [16] Zhao C, Fan L, Qi F, et al. Raltitrexed plus oxaliplatin-based transarterial chemoembolization in patients with unresectable hepatocellular carcinoma. Anticancer Drugs, 2016,27(7):689-694. [17] Cui W, Fan W, Zhang Q, et al. Comparison of two transarterial chemoembolization regimens in patients with unresectable hepatocellular carcinoma: raltitrexed plus oxaliplatin versus 5-fluorouracil plus oxaliplatin. Oncotarget, 2017,8(45):79165-79174. [18] Shao W, Li C, Tang J, et al. Efficacy and safety of raltitrexed plus oxaliplatin-based transarterial chemoembolization in patients with unresectable hepatocellular carcinoma. Cancer Manag Res, 2019,11:9863-9869. [19] He J, Sun H, Li F, et al. Efficacy and safety of raltitrexed-based transcatheter arterial chemoembolization for intermediate and advanced hepatocellular carcinoma: a multicenter real-world study. Hepatol Res, 2021,51(11):1153-1163. [20] Bi Y, Wang Y, Zhang W, et al. Preliminary outcomes of DEB-TACE loaded with raltitrexed in the treatment of unresectable or recurrent hepatocellular carcinoma. Cancer Imaging, 2023,23(1):19. [21] Chen S, Yuan B, Yu W, et al. Hepatic arterial infusion oxaliplatin plus raltitrexed and chemoembolization in hepatocellular carcinoma with portal vein invasion: a propensity score-matching cohort study. J Surg Oncol, 2022,126(7):1205-1214. [22] Chen S, Zhang K, Liu W, et al. Hepatic arterial infusion of oxaliplatin plus raltitrexed in patients with intermediate and advanced stage hepatocellular carcinoma: a phase II, single-arm, prospective study. Eur J Cancer, 2020,134:90-98. [23] Wu Y, Zheng S, Zhang Z, et al. Hepatic arterial infusion chemotherapy with oxaliplatin plus raltitrexed as an alternative option in advanced hepatocellular carcinoma patients with failure of, or unsuitability for, transarterial chemoembolization. Medicina (Kaunas), 2022,58(10):824-828. [24] Chen S, Yu W, Zhang K, et al. Hepatic arterial infusion of oxaliplatin plus raltitrexed in unresectable hepatocellular carcinoma with or without portal vein tumour thrombosis. Gastroenterol Rep (Oxf), 2022,10:goac16. [25] Kraj L, Chmiel P, Gryziak M, et al. Impact of thrombocytopenia on survival in patients with hepatocellular carcinoma: updated meta-analysis and systematic review. Cancers (Basel), 2024,16(7):432-435. [26] Leung J H, Wang S Y, Leung H, et al. Comparative efficacy and safety of multimodality treatment for advanced hepatocellular carcinoma with portal vein tumor thrombus: patient-level network meta-analysis. Front Oncol, 2024,14:1344798. [27] Tan Z, Zhang J, Xu L, et al. Triple combination of HAIC-FO plus tyrosine kinase inhibitors and immune checkpoint inhibitors for advanced hepatocellular carcinoma: a systematic review and meta-analysis. PLoS One, 2023,18(10):e290644. [28] 徐永康, 付舒敏, 李丹, 等. 肝动脉灌注化疗联合系统治疗在原发性肝癌中的研究进展. 介入放射学杂志, 2023,32(01):94-97. [29] National Health Commission Of The. 原发性肝癌诊疗指南(2024年版). 临床肝胆病杂志, 2024,40(05):893-918. [30] Ge N, Wang H, He C, et al. Optimal interventional treatment for liver cancer: HAIC, TACE or iTACE?. J Interv Med, 2023,6(2):59-63. [31] Liu B, Gao S, Guo J, et al. Efficacy and safety of hepasphere drug-eluting bead transarterial chemoembolization combined with hepatic arterial infusion chemotherapy as the second-line treatment in advanced hepatocellular carcinoma. J Hepatocell Carcinoma, 2024,11:477-488. [32] Zhu L Z, Xu S, Qian H L. Transarterial embolization and low-dose continuous hepatic arterial infusion chemotherapy with oxaliplatin and raltitrexed for hepatocellular carcinoma with major portal vein tumor thrombus. World J Gastroenterol, 2018,24(23):2501-2507. [33] Liu B, Zhu X, Gao S, et al. Safety and efficacy of hepatic arterial infusion chemotherapy with raltitrexed and oxaliplatin post-transarterial chemoembolization for unresectable hepatocellular carcinoma. J Interv Med, 2019,2(2):91-96. [34] Tu X, Zhang W, Li S, et al. Efficacy of hepatic arterial infusion chemotherapy in patients with primary liver cancer with portal vein tumor thrombosis: a comparative analysis of different perfusion chemotherapeutic regimens. Eur J Med Res, 2024,29(1):465. [35] Cai M, Liang L, Zhang J, et al. Lenvatinib plus drug-eluting bead transarterial chemoembolization with/without hepatic arterial infusion chemotherapy for hepatocellular carcinoma larger than 7 cm with major portal vein tumor thrombosis: a multicenter retrospective cohort study. Int J Surg, 2024. [36] Mei J, Li S H, Li Q J, et al. Anti-PD-1 immunotherapy improves the efficacy of hepatic artery infusion chemotherapy in advanced hepatocellular carcinoma. J Hepatocell Carcinoma, 2021,8:167-176. [37] Zhou S A, Zhou Q M, Wu L, et al. Efficacy of hepatic arterial infusion chemotherapy and its combination strategies for advanced hepatocellular carcinoma: a network meta-analysis. World J Gastrointest Oncol, 2024,16(8):3672-3686. [38] Li Z, Xu Y, Qu W, et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with immune checkpoint inhibitors and tyrosine kinase inhibitors in advanced hepatocellular carcinoma: a systematic review and meta-analysis. Oncol Lett, 2023,26(6):534. [39] Chen S, Shi F, Wu Z, et al. Hepatic arterial infusion chemotherapy plus lenvatinib and tislelizumab with or without transhepatic arterial embolization for unresectable hepatocellular carcinoma with portal vein tumor thrombus and high tumor burden: a multicenter retrospective study. J Hepatocell Carcinoma, 2023,10:1209-1222. [40] Wang W, Li R, Li H, et al. Addition of immune checkpoint inhibitor showed better efficacy for infiltrative hepatocellular carcinoma receiving hepatic arterial infusion chemotherapy and lenvatinib: a multicenter retrospective study. Immunotargets Ther, 2024,13:399-412. [41] Zang M, Hu X, Yuan G, et al. Tyrosine kinase inhibitors, immune checkpoint inhibitors combined with hepatic arterial infusion of oxaliplatin and raltitrexed versus oxaliplatin, 5-fluorouracil and leucovorin for intermediate and advanced hepatocellular carcinoma: a retrospective study. Int Immunopharmacol, 2023,125(Pt A):111019. [42] Luo L, Xiao Y, Zhu G, et al. Hepatic arterial infusion chemotherapy combined with PD-1 inhibitors and tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a tertiary medical center experience. Front Oncol, 2022,12:1004652. [43] 李榕, 李文利, 胡晓云, 等. RALOX-HAIC联合免疫检查点抑制剂及靶向药物治疗中晚期肝癌的疗效分析. 中国肿瘤临床, 2023,50(11):555-560. [44] Xiao Y, Deng W, Luo L, et al. Beneficial effects of maintaining liver function during hepatic arterial infusion chemotherapy combined with tyrosine kinase and programmed cell death protein-1 inhibitors on the outcomes of patients with unresectable hepatocellular carcinoma. BMC Cancer, 2024,24(1):588. [45] Xiao Y, Zhu G, Xie J, et al. Pretreatment neutrophil-to-lymphocyte ratio as prognostic biomarkers in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy combined with lenvatinib and camrelizumab. J Hepatocell Carcinoma, 2023,10:2049-2058. |
[1] | 张萌, 党至纯, 李婷, 刘晨瑞, 王沐淇, 吴姣姣, 贺娜, 李亚萍. 肝硬化合并与不合并原发性肝癌患者血小板数目及凝血功能差异比较研究*[J]. 实用肝脏病杂志, 2025, 28(4): 577-580. |
[2] | 彭贺, 郝建玲, 黄建业, 李楠楠, 骆锦前. TACE术联合靶向和免疫治疗原发性肝癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(4): 593-596. |
[3] | 杨懿瑾, 洪晗, 陈彬, 崔洪全, 王逸, 张甲. FOLFOX肝动脉灌注化疗联合仑伐替尼和PD-1抑制剂治疗中晚期原发性肝癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(3): 426-429. |
[4] | 董彦宏, 姜琨, 黄辉, 彭钊, 程艾. MRI扫描评估原发性肝癌患者TACE术后病灶残留价值研究*[J]. 实用肝脏病杂志, 2025, 28(3): 434-437. |
[5] | 陈思雨, 庞永平, 宋云鹏, 乔海霞. TACE联合靶向和免疫治疗中晚期肝细胞癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(2): 258-261. |
[6] | 张华, 钟焕辉, 旷艳春, 顾晖, 洪勇, 徐化交, 陈勉, 刘海生. 肝癌切除术后应用右美托咪定复合舒芬太尼和布托啡诺静脉自控镇痛效果研究*[J]. 实用肝脏病杂志, 2025, 28(2): 266-269. |
[7] | 申磊, 胡晓露, 张青和. 肝癌根治性切除术后延迟性肠麻痹发生预测模型的构建与验证*[J]. 实用肝脏病杂志, 2025, 28(1): 132-135. |
[8] | 王海霞, 刘忠涛, 张苗苗. 右美托咪定麻醉处理接受肝叶切除术治疗的原发性肝癌患者对肝缺血再灌注损伤的影响分析*[J]. 实用肝脏病杂志, 2025, 28(1): 136-139. |
[9] | 邓娜, 郑玉凤, 刘旭红, 韩晓兵, 丁碧娇, 曾纬阳, 刘娜红, 黄莹, 陈梅桂. CT动态增强扫描诊断原发性肝癌效能分析*[J]. 实用肝脏病杂志, 2024, 27(6): 919-922. |
[10] | 陶巧建, 仲华根, 周绍荣, 潘洪喜, 王应杰. 瑞马唑仑复合小剂量丙泊酚诱导麻醉肝癌切除术患者镇静和认知功能恢复比较研究*[J]. 实用肝脏病杂志, 2024, 27(6): 923-926. |
[11] | 武文华, 蔡芝芳, 李亚萍, 贾晓黎, 党双锁. 肝动脉化疗栓塞联合射频消融治疗原发性肝癌患者血清炎症因子变化及其对远期生存率的影响*[J]. 实用肝脏病杂志, 2024, 27(6): 927-930. |
[12] | 王冬梅, 李俊, 徐滨, 马欢, 徐兴军, 芦东徽. 卡瑞利珠联合靶向治疗原发性肝癌患者疗效及安全性分析*[J]. 实用肝脏病杂志, 2024, 27(5): 765-768. |
[13] | 陈海琳, 杨涛, 周云. 原发性肝癌患者双源CT全肝灌注成像特点及对TACE术后残余病灶的评估价值*[J]. 实用肝脏病杂志, 2024, 27(5): 769-772. |
[14] | 张晓云, 夏婧, 张智华, 黄松梅. 罗哌卡因腹横肌平面阻滞麻醉处理腹腔镜下肝癌切除术患者镇痛效果分析*[J]. 实用肝脏病杂志, 2024, 27(5): 773-776. |
[15] | 王秀芝, 常金, 宋丹, 谭亭昭. 卡瑞利珠单抗联合阿帕替尼治疗晚期原发性肝癌患者效果研究*[J]. 实用肝脏病杂志, 2024, 27(4): 591-594. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||