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虽然肝细胞癌(HCC)治疗取得了长足进步,但处理合并门静脉血栓(PVT)的HCC仍具挑战性。在确诊的HCC患者中有10%~40%存在PVT,而其治疗方案却非常有限。目前的指南主要介绍了索拉非尼对合并PVT晚期HCC的治疗,但手术、动脉化疗栓塞、外放射治疗、放射性栓塞、动脉灌注化疗、联合治疗仍在使用,且一些新兴的疗法(如免疫治疗剂和溶瘤病毒)也正在研究中。故对于合并PVT的HCC来说,联合索拉非尼的局部治疗仍是一个值得积极研究的领域,今后需开展和进一步验证有效的联合治疗方案,并将其作为临床努力的方向。
Although there has been considerable progress in the treatment of hepatocellular carcinoma (HCC), the management of HCC with portal vein thrombosis (PVT) remains challenging. PVT is diagnosed in 10% to 40% of patients diagnosed with HCC and its treatment regimen is very limited. The current guideline focuses on sorafenib for advanced HCC with PVT but surgery, arterial chemoembolization, external beam radiotherapy, radioactive embolization, arterial infusion chemotherapy and combination therapy are still in use and some emerging therapies such as immunization Therapeutic agents and oncolytic viruses) are also under study. So for the combined PVT of HCC, the combined treatment of sorafenib is still a field worthy of active research, the future need to carry out and further validation of effective combination therapy, and as the direction of clinical efforts.