肝癌治疗分级与集合治疗模式建立最终修稿.docVIP

肝癌多学科综合治疗的分级与集合治疗模式的建立 王悦华1，刘永雄2 摘要 目的：提出肝癌治疗分级新概念，建立肝癌治疗新模式。方法：根据肝癌既是局部病变，又是全身性疾病的特点，提出肝癌治疗新理念。依据肝癌治疗方法的治疗目标和，提出不同于传统的按学科分类的肝癌治疗分级方法。根据肝癌各级治疗目标与治疗方法之间的关系，建立肝癌治疗新模式。结果：提出了全方位、系统化、规范化、个体化、动态式、经济型的肝癌治疗新理念。肝癌的治疗目标包括局部肿瘤病灶、肝内的转移、全身性播散、慢性肝病、全身康复等六个方面，肝癌的治疗方法则相应地分为六级（G1~G6）。建立了以治疗目标选择治疗方法的肝癌集合治疗模式（ATM），其数学概念是ATM∈{G1,G2,…,Gn}结论：所建立的肝癌ATM了各项治疗之间的内在关系，可用于肿瘤治疗方案的策划治疗。 关键词：癌，肝细胞, 治疗方案，治疗模式，数学模型 本课题受国家自然科学基金资助（项目批准号：。 作者单位：1首都医科大学宣武医院普外科，（北京市宣武区长椿街45号 100053） 2解放军总医院肝胆外科，（北京市海淀区复兴路28号 100853） 通讯作者：王悦华，E-mail: wangyuehua301@ Classification of multidisciplinary synthetic therapy and creation of aggregate treatment mode for hepatocellular carcinoma. WANG Yuehua1, LIU Yongxiong2. 1.Department of General Surgery, Xuanwu Hospital, Capital Medical University. Beijing 100053, China. 2. Department of Hepatobiliary Surgery, PLA General Hospital, Beijing 100853, China ABSTRACT Objective：To introduce a new concept of classification and gradation of cancer therapy for hepatocellular carcinoma (HCC) and establish a novel treatment mode. Methods：Tthe new therapeutic concepts were proposed based on current knowledge about partial and general features of tumors. A new concept of classification and gradation of HCC therapy was introduced based on the different primary aims and mechanisms of treatment as opposed to previous traditional classifications. A novel treatment mode for HCC therapy was established according to the relationship between the objective and method of treatment. Results： Six basic principles for planning HCC therapy were proposed, which were all-around and systematic, standardized and individualized, dynamic and economic. The objective of HCC therapy includes six aspects such as the tumor focus, latent cancer cells in the liver, metastases and free cancer cells theoretically exist in blood, chronic liver disease, homeostasis and oncology rehabilitation etc. The total treatment was subdivided into 6 grades (G1 ~G6) accordingly. An aggregate treatment mod