经动脉治疗在肝肿瘤中的角色
Roles of Transarterial Therapy in Liver Malignancies

挽救性治疗 Salvage therapy

全身治疗失败或无效 Systemic therapy inefficient or failed

辅助治疗 Adjuvant therapy ·

全身治疗期间巩固治疗 Augmentation during systemic therapy 

全身治疗失败后的初始治疗 Primary therapy when systemic chemotherapy is not an option or ineffective 

胆管癌 Cholangiocarcinoma, Adenoid cystic ca

高龄

消融或外科治疗前桥接或降期治疗 Bridging or downstaging measures before focal ablation or surgery CRC Liver Metastases

理想的TACE：principle & angiodynamic

联合局部缺血（栓塞）和细胞毒性效应（化疗药物） Combined local ischemic and cytotoxic effect
巩固受过效应 Augments 1st pass effect
在肿瘤血管床的深处提供持续高浓度的化疗药物Provide maximum and sustained concentration of the chemotherapeutic drug deep into the tumor bed
保持血管的开放 Preserve vessel patency
精准肿瘤血管阻塞 Calibrated tumor vessel obstruction
低或相对低的化疗毒性的全省暴露 Low or lower systemic exposure of chemotoxicity
避免缺血时间拖延和VEGF上调 Avoid prolonged ischaemia & VEGF upregulation

近端动脉阻塞 Proximal arterial occlusion
不均匀的药物分布 Inhomegenous drug distribution
化疗药物的不可预测的释放时间 Unpredictable time release of chemotherapeutic agent
半数致死剂量未被定义或不充分的细胞毒性效应 LD50 undefined or inadequate cytotoxic effect
永久性血管闭塞，导致VEGF上调，刀子肿瘤风暴/进展 Permanent devascularisation inducing upgrading of VEGF and tumour storm/progression