简要介绍
Hepatic artery infusion chemotherapy (HAIC) is a well-established and common treatment for advanced hepatocellular carcinoma (HCC), particularly in East Asia.
肝动脉输注化疗(HAIC)是一种成熟的和常见的治疗晚期肝癌(HCC)的治疗方法，特别是在东亚地区。
However, HAIC is not recognized internationally.
然而，HAIC并没有得到国际认可。
Although several trials have demonstrated the safety and efficacy of HAIC, evidence corroborating its overall survival (OS) benefits compared with standard treatments is insufficient.
虽然一些试验已经证明了HAIC的安全性和有效性，但与标准治疗相比，证实其总生存期(OS)的益处是不够的。
Nevertheless, HAIC may provide prominent benefits in selected patients such as patients with portal vein thrombosis or high intrahepatic tumor burden.
然而，HAIC可能在选定的患者中提供显著的好处，如门静脉血栓形成或高肝内肿瘤负荷的患者。
Moreover, HAIC has been combined with several therapeutic agents and modalities, including interferon-alpha, multikinase inhibitors, radiation therapy, and immunotherapy, to augment its treatment efficacy.
此外，HAIC已与多种治疗药物和治疗方式联合使用，包括干扰素-阿尔法、多激酶抑制剂、放射治疗和免疫治疗，以提高其治疗效果。
Most of these combinations appeared to increase overall response rates compared with HAIC alone, but results regarding OS are inconclusive.
与单独使用HAIC相比，大多数这些组合似乎增加了总体缓解率，但关于OS的结果尚不确定。
Two prospective randomized controlled trials comparing HAIC plus sorafenib with sorafenib alone have reported conflicting results, necessitating further research.
两项比较HAIC加索拉非尼和单独加索拉非尼的前瞻性随机对照试验报告了相互矛盾的结果，需要进一步的研究。
As immunotherapy-based combinations became the mainstream treatments for advanced HCC, HAIC plus immunotherapy-based treatments also showed encouraging preliminary results.
随着基于免疫治疗的联合治疗成为晚期HCC的主流治疗方法，HAIC+基于免疫治疗的治疗也显示出了令人鼓舞的初步结果。
The trials of HAIC were heterogeneous in terms of patient selection, chemotherapy regimens and doses, HAIC combination agent selections, and HAIC technical protocols.
HAIC的试验在患者选择、化疗方案和剂量、HAIC联合药物选择和HAIC技术方案方面存在异质性。
These heterogeneities may contribute to differences in treatment efficacy, thus increasing the difficulty of interpreting trial results.
这些异质性可能导致了治疗效果的差异，从而增加了解释试验结果的难度。
We propose that future trials of HAIC standardize these key factors to reveal the clinical value of HAIC-based treatments for HCC.
我们建议未来的HAIC试验将这些关键因素标准化，以揭示基于HAIC的HCC治疗的临床价值。
肝动脉灌注化疗，Hepatic artery Infusion Chemotherapy，简称HAIC按肿瘤药物对肿瘤的生物学效应包括 1. 肿瘤对药物的敏感性 2. 肿瘤与药物的接触时间 3. 肿瘤与药物的接触浓度 2020年《中国临床肿瘤学会（CSCO）原发性肝癌诊疗指南》指出以下类型患者推荐使用肝动脉灌注化疗：
虽然超出该标准的病人并非不适合肝动脉灌注化疗，只是通过该方案治疗后达到根治性切除的可能性相对较低。而即使符合该标准的病人，也有部分难以达到预期的转化结果。
以前常用肝动脉灌注化疗采用阿霉素或顺铂方案，以阿霉素或顺铂为基础的化疗方案疗效并不理想。现在对于原发性肝癌还是结直肠癌肝转移的患者，都主要采用以奥沙利铂为基础的FOLFOX方案（奥沙利铂，氟尿嘧啶，亚叶酸钙）。FOLFOX方案是晚期肝癌和结直肠癌获批的全身化疗方案，在晚期肝癌和结直肠癌患者中都展示出生存获益。 |