Primary liver cancer should be how to treat?

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      early treatment is the most important factor to improve the prognosis of liver cancer, early liver cancer should be tak


      early treatment is the most important factor to improve the prognosis of liver cancer, early liver cancer should be taken as far as possible to the resection of large liver cancer can not be treated with multi-mode comprehensive treatment

    (a) for surgical treatment of hepatocellular carcinoma with surgical resection is the first choice for early tumor resection is the key to improve the survival rate of the five year survival rate of higher surgical indications: 1 diagnosed lesions confined to the estimation one or half liver; without obvious jaundice or ascites distant metastasis in the liver; compensatory function is good thrombin time of not less than 50%; the liver and kidney function tolerance in normal liver function liver excision quantity does not exceed 70%; liver cirrhosis is less than 50% or only can make the left hepatectomy; severe liver cirrhosis cannot be liver resection surgery and pathology confirmed more than 80% recognized with liver cirrhosis with local excision instead of regular hepatic lobectomy without the same effect and postoperative liver dysfunction to reduce operative mortality is reduced due to excision still has quite high recurrence rate after surgery should be so regularly AFP and ultrasound. To monitor recurrence

The radical resection were followed up closely is often detected in small hepatocellular carcinoma in sub clinical stage "recurrence reoperation as a method of foreign reported more preferred after the second operation, five years survival rate was still 38.7% although liver transplantation is in the treatment of hepatocellular carcinoma but in the treatment of liver cancer in a long time has not been confirmed after operation the application of long term immunosuppressive patients often died of recurrence of developing countries due to donor origin and cost problems in recent years is still difficult to promote

(two) palliative surgical treatment for large tumors or scattered in or near the area of large blood vessels or cirrhosis and unresectable hepatic artery ligation method and (or) microwave therapy for hepatic artery catheterization chemotherapy in the treatment of hepatic artery embolization in frozen laser treatment or percutaneous ethanol injection and sometimes can cause tumors to shrink in serum AFP declined to provide opportunities for the two step resection

(three) multi model comprehensive treatment is in the medium-term liver cancer effective therapy of unresectable liver cancer is sometimes made into small hepatocellular carcinoma and its methods for more and more generally to the hepatic artery ligation plus hepatic artery catheterization chemotherapy two based external radiation therapy for triple combined immunization treatment with triple quadruple above the best by mode of comprehensive treatment in patients with tumor shrinkage rate of 31% was significantly reduced by two step for tumor resection in two step resection rate was 38.1% in Shanghai Medical University Cancer Institute also studied hyperfractionated radiotherapy and guide treatment hyperfractionated radiation and hepatic artery catheterization combined with chemotherapy in the treatment of the method is: first week of transcatheter arterial chemotherapy cisplatin (CDDP) 20mg daily for 3 consecutive days of local second weeks of liver tumor radiation area on the afternoon of the 2.5Gy (250rads) for 3 consecutive days; so every two weeks for a course Alternate weeks can be repeated 3 to 4 course oriented therapy with 131I- anti hepatoma ferritin antibody or anti hepatoma monoclonal antibody or 131I-lipiodol hepatic artery catheter injection every 1 ~ February a treatment interval artery CDDP internalization of 20mg once a day for 3 to 5 days if the above treatment plus immunotherapy such as interferon letinous edodes white polysaccharide -2 is better

(four) hepatic artery chemoembolization (TAE) this is a cancer treatment with non surgery in 80s the development of hepatocellular carcinoma has very good curative effect and is recommended as the preferred solution of non operative therapy in the use of iodized oil (lipiodol) mixed method chemotherapy drugs or 131I or 125I-lipiodol or 90 yttrium microsphere embolization of tumor and distal blood supply gelatin sponge embolization of tumor of proximal hepatic artery make it difficult to establish collateral circulation resulting in tumor necrosis CDDP80 plus 100mg5Fu chemotherapy drugs commonly used to 1000mg 10mg or mitomycin doxorubicin (ADM) 40 ~ 60mg first arterial perfusion (MMC) and mitomycin 10mg in mixed phacoemulsification Lipiodol within the distal embolization of hepatic artery embolism chemotherapy of hepatic artery good treatment effect should be repeatedly according to the radiology department data of 345 cases of unresectable hepatocellular carcinoma with large hepatic artery perfusion one year survival rate is only 11.1% And hepatic artery embolization in the treatment of one year survival rate increased to 65.2%, the longest 52 months followed up, 30 cases of tumor resection was reduced opportunity for severe liver function decompensation of the French taboo tumor thrombus in the main portal vein obstruction is not appropriate

(five) ethanol injection under ultrasound guided percutaneous transhepatic intratumoral injection of anhydrous alcohol in the treatment of hepatocellular carcinoma with tumor diameter less than 3cm nodules in less than 3 were associated with cirrhosis and unresectable hepatocellular carcinoma is the first choice for small hepatocellular carcinoma may cure 5cm or poor effect

(six) radiotherapy due to the accurate positioning check progress of radiation sources of various imaging equipment and technology to make the status of radiotherapy in the treatment of liver cancer has also improved to improve the efficacy of radiotherapy for unresectable hepatocellular carcinoma tumor is still confined to large dose tolerance usually its curative effect is better after radiotherapy in the treatment of hepatic local radiotherapy radiation whole liver moving radiation local hyperfractionation radiotherapy stereotactic radiation near a total of more than useful proton as hepatoma radiotherapy have reported a total of more than 40Gy (4000rads radiation gasvolume) combined with traditional Chinese medicine spleen makes a year survival rate of 72.7% and five years survival rate was 10% and operative chemotherapy could play a role in killing the remaining cancer chemotherapy can be adjuvant radiotherapy sensitization effect of hepatic artery injection of Y-90 microspheres 131I- or lipiodol isotope labeled monoclonal antibodies can play in radiation therapy effect

    (seven) noninvasive treatment of hepatocellular carcinoma ( ); ultrasound ablation for primary liver cancer is a new technique for noninvasive tumor therapy. Through my center hundreds of liver ultrasound ablation treatment has obvious curative effect. With the treatment of liver cancer center physician knowledgeable and rich clinical experience, the use of the most advanced HIFU focused ultrasound knife, ultrasound combined with minimally invasive vascular intervention, low price and practical treatment of liver cancer or intravascular injection of interventional therapy, immune therapy and other unique curative effect, slight trauma liver cancer treatment of new technology and new method, not only for early HCC, and of late, very large, intrahepatic vascular metastasis, various other methods of long treatment of liver cancer embolus, recurrence, residual, intrahepatic metastasis were treated, has made a very good therapeutic effect. Due to the unique characteristics of ultrasound ablation, such as no trauma, no radiation, immune enhancement, so that the patient's pain to a minimum, the highest efficacy.

            (eight) directed therapy using specific antibody and monoclonal antibody or pro tumor chemical drugs as a carrier or with chemotherapy or radionuclide labeled immunotoxin for cross-linking specific targeting therapy is one of the promising antibody has been used in clinical therapy with anti human liver cancer protein the antibody of anti hepatoma monoclonal antibody anti AFP monoclonal antibody "warhead" except 131I125I have tried 90Y in addition to toxin and chemotherapy and antibody cross-linking of human monoclonal antibody or gene engineering antibody under study

(nine) chemotherapy is effective for liver cancer with CDD[P as the preferred common and 5Fu adriamycin (ADM) and its derivatives of mitomycin VP16 and methotrexate, generally single drug intravenous administration with poor curative effect of hepatic artery embolization and (or) and cooperate external radiation therapy has obvious effect on some more applications no surgical indications of advanced hepatocellular carcinoma and portal vein tumor thrombus occlusion for hepatic artery interventional therapy and palliative surgery patients can be combined or sequential chemotherapy regimen used for cisplatin 20mg+5Fu750mg ~ 100mg intravenous drip for 5 days once a month from 3 to 4 times for a period of 40 to adriamycin 60mg first day followed by 5Fu500mg ~ 750mg intravenous drip for 5 days once a month for 3 ~ 4 times for a course of treatment the effect evaluation of a scheme

(ten) biological treatment biological treatment not only with surgery chemotherapy and radiotherapy to relieve the inhibition of immune elimination of residual tumor cells. In recent years due to the development of gene recombination technology to obtain a large number of immunological factors or cytokines can be used recombinant lymphokines and cytokines biological response regulator (BRM) on tumor biological treatment caused widespread concern in the medical profession has been considered to be the fourth anti tumor therapy has been widely used in clinic at present alpha and gamma interferon (IFN) treatment of natural and recombinant IL-2TNF has been in lymphokine activated killer cells -LAK cells of tumor infiltrating lymphocytes (TIL) have begun to effect biological treatment agent used for trial remains to be more the practice and summary of biological therapy for hepatocellular carcinoma gene therapy provides a new prospect

(eleven) Chinese herbal medicine Chinese herbal medicine is also available on the effect of Fuzhengkangai patients and liver function of advanced hepatocellular carcinoma with severe decompensation cannot tolerate other treatment can improve the body condition to extend the life of the surgical operation combined with radiotherapy and chemotherapy to improve the efficacy and reduce adverse reaction

Conclusion early HCC resection should be sooner or later preferred unresectable hepatic artery chemoembolization, percutaneous ethanol injection for liver function is poor for the treatment of small hepatocellular carcinoma may play a radical effect; the middle large hepatocellular carcinoma should be used for hepatic artery catheterization ligation based multi mode therapy or hepatic artery embolization chemotherapy to reduce tumor killing tumor cells when the tumor reduced to load the integrative treatment of two step sequential or surgical resection for advanced hepatocellular carcinoma with Chinese herbal medicine mainly to improve symptoms and prolong the survival time of therapy has achieved initial success has prospects in gene therapy

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