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2015 ; 21
(28
): 8478-91
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Current and future treatments for hepatocellular carcinoma
#MMPMID26229392
Schlachterman A
; Craft WW Jr
; Hilgenfeldt E
; Mitra A
; Cabrera R
World J Gastroenterol
2015[Jul]; 21
(28
): 8478-91
PMID26229392
show ga
Hepatocellular carcinoma (HCC) represents a unique challenge for physicians and
patients. There is no definitively curative treatment. Rather, many treatment and
management modalities exist with differing advantages and disadvantages. Both
current guidelines and individual patient concerns must be taken into account in
order to properly manage HCC. In addition, quality of life issues are
particularly complex in patients with HCC and these concerns must also be
factored into treatment strategies. Thus, considering all the options and their
various pros and cons can quickly become complex for both clinicians and
patients. In this review, we systematically discuss the current treatment
modalities available for HCC, detailing relevant clinical data, risks and rewards
and overall outcomes for each approach. Surgical options discussed include
resection, transplantation and ablation. We also discuss the radiation
modalities: conformal radiotherapy, yttrium 90 microspheres and proton and heavy
ion radiotherapy. The biologic agent Sorafenib is discussed as a promising new
approach, and recent clinical trials are reviewed. We then detail currently
described molecular pathways implicated in the initiation and progression of HCC,
and we explore the potential of each pathway as an avenue for drug exploitation.
We hope this comprehensive and forward-looking review enables both clinicians and
patients to understand various options and thereby make more informed decisions
regarding this disease.
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