Liver cancer various treatment method

A, the surgical operation treatment surgical operation treatment is still currently a head of curing the liver cancer to choose a method.In recent years because of liver cancer of the earlier period diagnose, the renewal progress of surgery some concepts of the fixed position diagnosis, tumor biology and liver cancer, make the surgery treatment effect of liver cancer had an obvious exaltation.Mainly include following few kinds:
1.The surgical operation excision cures 2.Various partial treatment in the Shu that can not cut off:①The liver artery vein chemotherapy in the door in Shu also ligatures;②Place into a type to note a medicine pump to lose to note a chemotherapy;③Place into on the decline wave in the Shu radiation treatment;④The refrigeration in Shu cures;⑤It gives or gets an electric shock a chemistry treatment in the Shu;⑥Three benzene oxygen the An add liver to infuse to note a chemotherapy;⑦The preface Guan of liver cancer cures.
Two, project treatment in recent years along with project physics and project physiology of research make progress, made progress to put to treat an equipments, adopted a cobalt 60 γs shoot the X of line or electronics linear accelerator to shoot line, Gao to shoot line etc. and also had an improvement to irradiation method and scope of liver cancer, from original whole liver irradiation-the partial irradiation-whole liver ambulation put the irradiation-surgical operation fixed position part irradiation and super partition irradiation etc., make the liver cancer put a curative effect fruit to contain obvious exaltation, the side effect then is as low as lowest level.Mainly include a body to outside project treatment and project a treatment inside the body.
Three, the chemistry medicine cures 95% patients of liver cancer have already lost a surgical operation opportunity while diagnosing, majority of treatments that the sufferer of liver cancer still depends on chemistry medicine.Had high evaluation to the chemotherapy of liver cancer formely, particularly is had very tiny curative effect for medicine all over and changed a chemotherapy in recent years of go liver artery chemotherapy to the medicine path and bolt to fill, make the chemotherapy effect of liver cancer had an obvious exaltation.Currently think to put tube chemotherapy better than whole body consociation chemotherapy, consociation chemotherapy better than single medicine chemotherapy.Liver artery's putting a tube chemotherapy is thought is the patient whom the not proper surgical operation cures liver cancer of had better therapy.
Four, get involved emanation to learn to cure rise in 80's and get a quick development of Be infused to note a chemotherapy by the skin chamber super selectivity liver artery and bolt to fill of get involved emanation to learn a technique to develop to the pass important function.No matter limited sex liver cancer in early days or medium the later period liver cancer cured, this getting involved emanation to learn techniques were all decisive treatment methods, essential to have.
Five, immunity treatment the domestic successively once tried out bcg vaccine, small good form rod bacteria and left Xuan Mi the Shi and lump seedling, embryo cell and thymus gland is plain and transfered the factor, immunity pit sugar nucleic acid etc., but all didn't meet with obvious curative effect.Apply to there is morely an interferon, white cell lying a vegetable in recent years-the Ⅱ and lymphoid factor activate of killing and harming cell etc., the list is used or unite other therapies can the treatment effect of the degree different exaltation liver cancer.
Six, the absolute alcohol inject a treatment in recent years, in the B under the super guide the absolute alcohol inject the clinical report way of curing the liver cancer a lot of.The this kind therapy has more obvious effect in the aspects of narrowing a focus, control and defer tumor growth, because of adopting this therapy doesn't need a special condition, the operation method is simple, the complications is little, the patient is painful small, the expenses is low, so clinical usage very universal.
Seven, the laser dynamics cure a super voice to guide next carry on the liver cancer partial laser to project light upon and infused into chemotherapy medicine to obtain better effect in the meantime.
Eight, the super voice guide the microwave concretion cure this kind therapy to be applicable to small liver cancer.
Nine, direction treatment direction the treatment make use of a kind of antibody or compound that has special affinity to the liver cancer to make "carry a body", or pass a physical function direction like Ci, or pass the tumor afferent particularity the direction is like iodine oil, again with have "warhead"(radio pit vegetable, chemotherapy medicine, poisonous egg white, and BRM...etc.) to kill wound tumor function to make into to hand over allied thing with attain more kill wound tumor but less injure the purpose of normal organization.
In early days cured is the most factor that improved liver cancer to prepare behind.The liver cancer should as far as possible adopt surgical operation excision in early days.May also adopt the comprehensive treatment of many modes to the big liver cancer that can not cut off.
(A)the treatment of surgical operation treatment liver cancer be still led by surgical operation excision to choose, in early days cut off is the key that raised an existence rate, the tumor was more small, five year, the existence led more high.The surgical operation adapts to a certificate for:①The diagnosis is explicit and estimate the pathological changes one who limit at one leaf or half liver;②Have no obvious jaundice, stomach water or distance assignor;③Liver function generation the Chang is still good, Ning blood Mao time the one who be no lower than 50%;④The heart, liver and kidney function one who bear to be subjected to.Normal in the liver function the liver cut off quantity more than 70% is not;Mid-degree cirrhosis not more than 50%, or only can do left half liver excision;The serious cirrhosis doesn't can do liver the leaf cut off.Surgical operation and pathology confirm that about above 80% liver cancer merges cirrhosis, generally accepted replace rule with the partial excision liver leaf the excision have no period effect homology, while the liver function mess ease after the Shu, the surgical operation death rate as well lowers.In order to curing for good to cut off to still have to very and highly relapse a rate, proper periodical reexamination AFP and the super voice shows elephant to relapse by inspecting after the past Shu.
Because cure for good resection behind with visit closely, past often examine"second clinical period" relapses of small liver cancer, is with again surgical operation for head choose, for the second time after operation five year, existence the rate still can reach to 38.7%.Although the liver transplantation doesn't lose for a kind of method that cures liver cancer, the foreign report way is more,is curing the position in the liver cancer to don't get a confirmation over a long period of time, the application of long term immunity depressant after Shu, the patient often dies in to relapse.To the developing country but square, still hard because of providing body source and fee problem recent years expansion.
(Two)the appeasement surgery treatment is suitable for bigger tumor or spread is distributing or close to big afferent area, or merge cirrhosis restriction but can not cut off, the method includes the liver artery the ligation and(or) the liver artery put tube chemotherapy, freeze, laser treatment, microwave treatment, the liver artery in Shu bolts to fill treatment or injects inside the absolute alcohol lump...etc., sometimes can make the tumor narrowed, serum AFP descends, for two excision opportunity to provide.
(Three)the comprehensive treatment of many modes is a recent years the big liver cancer is to the middle actively effective treatment method, sometimes make the big liver cancer that can not cut off of change for can cut off smaller liver cancer.Its method contains variety, generally many with liver artery the ligation add liver artery put tube chemotherapy of two allied way for foundation, add outside project treatment to three allied, such as merger the immunity cure four to unite.With three unite above effect the best.Be synthesized the treatment sufferer's tumor to narrow a rate to reach to 31% by many modes, obviously narrow and get two excisions because of the tumor, two excisions lead up to 38.1%.Medicine department university liver cancer graduate school in Shanghai as well once studied super partition put treat and lead to treatment, emanation outside the super partition and liver artery put tube chemotherapy united the method of treatment BE:The liver artery chemotherapy inside the pipe the first week agreeable everyday of platinum(CDDP) of chlorine ammonia 20 mgs, continuous 3 days.
The liver tumor area partial outside projects the second week up, in the afternoon each 2.5 Gies(250 radses), continuous 3 days;Two weeks for on treating a distance, separate a week to replace re-usable 3~4 to treat a distance thus.Direction treatment, with the 131 Is-anti- liver cancer 1000-year egg white antibody or the anti- liver cancer single gram of Long antibody or the 131 Is-lipiodol liver artery pipe inside inject, every 1~2 months once, the treatment expects to turn CDDP20 inside the artery mg everyday once, continuous 3~5 days.If the above-mentioned treatment adds an immunity treatment in the meantime much sugar is such as interferon, mushroom, white lie vegetable-2 classes and gradeses are better.
(Four)the liver artery bolts to fill a chemotherapy(TAE)
This is the tumor treatment of a kind of non- surgical operation that develops in 80's method, have very good curative effect to the liver cancer, even is recommended to choose a project for the non- surgical operation head within therapy.Adopt iodine more to turn the oil(lipiodol) mixture chemotherapy method the medicine or 131 Is or 125 Is-lipiodol, or 90 Yis tiny balls bolt to fill the tumor distant blood provides and bolt to fill tumor with the clear gum sea cotton again near carry liver of artery, make of the hard establishment side pay circulation and make the tumor focus lacked the blood bad dead.Chemotherapy medicine in common use CDDP is 80~ and add the 100 mgs 5 Fu1000 mg silk crack mildewed plain 10 mgs[or the mildewed plain(ADM)40~60 mgs], in advance infuse to note inside the artery, mix a silk crack's the mildewed plain(MMC)10 mgs again to bolt to fill at super voice the Lipiodol the expert distant liver artery for emulsifying.Liver artery's bolting to fill a chemotherapy should again and again cure for many times, the effect is better.According to my hospital project section data, 345 not the ability surgical operation cut off bigger liver cancer, the pure liver artery infuses to note a chemotherapy for a year, existence rate only is 11.1%, merger the liver artery bolt to fill to cure for a year, the existence rate raises to 65.2%, with visit existence to grow for 52 months most , 30 tumors narrow to get surgical operation excision an opportunity.Seriously lose a Chang to the liver function this method belong to taboo, the vein main stem cancer in door bolts to jam as well not agree with one.
(Five)inject a super voice to lead bottom inside the absolute alcohol lump Be worn to inside the tumor to infuse into an absolute alcohol treatment liver cancer through the skin liver.With the tumor diameter ≤ 3 cms, knot stanza number at 3 in the companion has cirrhosis but not ability the liver cancer of the surgical operation for head choose.Probably cure to the small liver cancer.The ≥ 5 cm effect is bad.
(Six)project treatment because of project source, project equipments and technical progress, various image learns the accurate fixed position of check to make to project treatment to have an exaltation in the under medical treatment position of liver cancer, the curative effect as well has an improvement.Project a treatment to be suitable for tumor to still limit of can not cut off liver cancer, usually such as the ability is subjected to bigger amount of, its curative effect is also better, outside project a treatment to experience the emanation, partial super partition emanation of the whole liver emanation, part emanation and whole liver ambulation, stereoscopic emanation total amount exceed the near useful proton make the emanation treatment of liver cancer.There is report way's the emanation total amount merging over the 40 Gies(the 4000 radses permits tolerance) reason spirit Jian Pi the Chinese herbal medicine makes for a year, the existence leads up to 72.7%, five years, the existence leads up to 10%, synthesizing a treatment with surgical operation, chemotherapy can have already killed to put out remnants cancer of function, chemotherapy may also assistance put to treat to increase a quick function.Inject inside the liver artery single gram of Long antibody etc. that the Y-90 tiny ball, 131 Is-iodine turns oil, or isotope marking can include inside project a treatment function.
(Seven)direction treatment application particularity antibody and single gram of Long antibody or kiss tumor of chemistry medicine in order to carry a body, marking pit vegetable or hand over with chemotherapy medicine or immunity toxin allied carry on a particularity direction treatment, is one of hopeful therapies.Clinical already the adoptive antibody have an anti- person the egg white antibody of the liver cancer and anti- person the liver cancer single gram of Long antibody, and anti- A the foetus egg white single gram of Long antibody...etc.."Warhead" has already tried out 90 Ys, in addition poisonous egg white and chemotherapy medicine and the handing over of antibody allied person's source single anti- or genetic engineering antibody etc. in the research now in addition to 131 I125 Is.
(Eight)the chemotherapy become more effective to liver cancer medicine with CDD[P for head chooses and in common usely still has a 5 Fus, the mildewed vegetable, VP16 and ammonia A Die purine etc. of the mildewed vegetable(ADM) and its derivatives, silk crack.Generally think single the medicine vein has worse curative effect for medicine.Adopt liver artery to the medicine and(or) bolt to fill, and match inside, outside project a treatment applied more, the effect is more obvious.To some in the liver cancer in later period have no surgical operation to advertise for, and vein main stem cancer in door's bolting to jam not proper liver artery to get involved treatment and some appeasements after operation a sufferer can adopt a consociation or preface Guan chemotherapy, in common use consociation project for the agreeable chlorine ammonia platinum 20 mgs+5 Fu750 mg~the 100 mg vein drop note for total 5 days, monthly once, 3~4 times for a treat a distance.The first day of the mildewed plain 40~60 mgs, after with 5 Fu500 mg~the 750 mg vein drop note continuously for 5 days, monthly once in a row 3~4 times for on treating a distance, above-mentioned project effect the evaluation is different.
(Nine)the living creature treatment living creature treatment not only rises match surgical operation, chemotherapy and puts to treat with ease to immunity of repress, exterminate remnants remaining tumor cell of function.In recent years, because the gene reorganizes a technical development and makes to acquire a great deal of immunity live factor or cell factor to make possible.Apply to reorganize lymphoid biological reactions, such as factor and cell factor...etc.'s regulating factor(BRM) have already caused medical science field to the tumor living creature treatment universal concern, it is the fourth anti- tumor to have already been thought treatment, clinical currently already widespreadly applied α and γ interferon(IFN) carries on a treatment, natural and reorganization IL-2, TNF already publishes, in addition, the lymphoid factor activates of kill gradually lymphoid cell(TIL) etc. of the wound cell-LAK cell tumor have already started trying out.The curative effect of various living creature treatment used needs more fulfillment and summaries.The gene treatment provideds new foreground for the living creature treatment of liver cancer.
(Ten)the Chinese herbal medicine Chinese herbal medicine hands just anti-cancer the function being applicable to the sufferer of the liver cancer in later period and liver seriously lose a Chang to bear to be subjected to other treatment, can rise improvement machine body whole body condition, extension life of function, may also match surgical operation, put to treat and chemotherapy with decrease bad reaction, raise curative effect.
Liver artery chemotherapy's bolting to fill the Shu(TACE) liver artery chemotherapy to bolt to fill Shu is in common use original hair liver cancer to get involved a treatment method currently and compare wound with surgical operation excision small, the instauration is quick and have equal curative effect to the small liver cancer and the surgical operation excision and be applicable to not ability the medium later period sufferer of the surgical operation or year old physically weak not the ability be subjected to sufferer of the surgical operation.Operation method the artery wears a sting and puts a tube from, until the liver leaf or liver segment artery injects chemotherapy medicine, then inserts tumor artery and infuses into super liquefaction iodine oil and clear gum sponge etc. and bolts and fills and block tumor and be provided for blood artery to make the tumor lack the blood bad dead.TACE develops very quickly, have become ability surgical operation not to cut off the head of liver cancer to choose a treatment method, the only complete vein cancer Shuan in door jams with serious vein in the cirrhosis door Gao is its taboo disease, majority of rest sufferers can carry on TACE treatment.
Inject the absolute alcohol direct function at the tumor cell through the skin absolute alcohol, can make the tumor cell changed sex bad dead, have already started universal application absolute alcohol injecting to cure liver cancer in the 80's in 20th century, it cures effect basic affirmation.The method generally wears to stab to tumor center and injects absolute alcohol through the liver from skin under the super guide in the B, the in common use measures a 2-3 mlscm.Apply diameter less than 5 cms liver cancer, because the tumor part is special, or the serious cirrhosis, or companion other dirty machine functions relapse after injuring not proper surgical operation excision and excision.But have in, a great deal of stomach water, heavy degree jaundice, Ning blood function obstacle, the pathological changes is extensive, knot stanza more than 5, or approach liver to wrap a film, have inside the liver or the distance transfer, whole body function bad and alcohol allergy, not proper application.
The radio frequency (RF) eliminates to melt Shu radio frequency be make use of medium Gao repeatedly electromagnetic wave creation of hot effect, make protein in the cell etc. life material changed sex, fat fuse cell membrane break, cause tumor to solidify bad dead, apply a radio frequency treatment towards discovering in the surgical operation the focus that can not cut off canning in the meantime.Be worn a sting radio frequency to eliminate to melt Shu as a kind of tiny technique for creating to get involved a treatment by skin liver under the super guide in the B in recent years, start getting into clinical, obtain to inject alike effect with absolute alcohol, be subjected to domestic and international liver cancer expert's concern.
The high strength focuses a super voice treatment(HIFU), HIFU with super voice wave for cure a source, make use of super voice wave of can see sex, soft organization penetrability and can focuse sex etc. the physics is special and focuse the body outside mentally retarded quantity super voice wave in the tumor inside the liver and produce Gao Neng's effect and make the tumor in the focus area organization break, but focus area outside organization department hurt, thus safety effective of break tumor organization.
In addition to above in common use method, there is still a refrigeration treatment, laser treatment and emanation getting involved treatment, and gene treatment...etc. all already in the clinical application, but delivered sex liver cancer at first currently up lack "particularity treatment" method, clinical various method applied mostly appeases sex treatment, regardless the surgical operation cut off or the non- surgical operation method Be each to have merit and shortcoming, they of repaired a function with each other.Therefore, the treatment progress that delivered sex liver cancer at first, in addition to actively developing a new method, more important comprehensive treatment of consociation various treatment methods.The comprehensive treatment will never be various treatment method to in brief fold to add, but according to the disease characteristics, sufferer's body condition and family economic condition, the treatment plan of establishment reasonable, apply more than two kinds of method consociation or preface Guan treatment.Developed to take TACE as axis to cure various comprehensive treatment modes of original hair liver cancer gradually for the last few years, like TACE+surgical operation cut off, TACE+the absolute alcohol inject, TACE+the radio frequency (RF) eliminate to melt Shu and TACE+project treatment and TACE+gene treatment and TACE+liver transplant etc..Currently several local hospitals completes liver cancer in the cooperation comprehensive get involved the norm of treatment to turn a project, then emollient push our country original hair liver cancer comprehensive get involved the development exhibition of curing the work, has good instruction function to the clinical work, the pathologic type, door vein that studied a detection to deliver sex liver cancer at first currently has have no cancer Shuan, have have no lymphoid knot or distance organ transfer a liver function circumstance, the sufferer's whole circumstance, synthesize to get involved the choice of the treatment object etc.s all influence liver cancer long-term curative effect main factor.The sufferer only has the treatment project of choice reasonable under the doctor's instruction, then can obtain satisfied treatment effect.