不可切除的结肠直肠癌肝转移治疗方案的进展

对于结肠直肠癌肝转移(CLM)患者而言,将肝转移灶完整切除是疾病治疗的重要目标之一。由于大多数患者在诊断初期肝转移灶是不可切除的,而采用化疗可以将肝转移灶降期使切除成为可能。对于不可切除的CLM患者接受全身化疗的研究已经证实,治疗反应率、肝转移灶切除率和生存率均有所提高。在最初不可切除的CLM患者中采用肝动脉灌注(HAI)联合氟尿嘧啶,同时辅助全身化疗的方法可以提高治疗反应率和肝转移灶切除率。所有的治疗策略应该由一个多学科团队共同制定。

Progression of the Therapy for Unresectable Colorectal Cancer Liver Metastases

Resection of colorectal liver metastases（CLM） is the ultimate aim of treatment strategies in most patients with liver-confined metastatic colorectal cancer.As a majority of patients have unresectable liver disease at the outset,there is a clear role for chemotherapy to downstage liver disease making resection possible.Studies of systemic chemotherapy in patients with unresectable CLM have resulted in increased response rates,liver resection rates and survival.Studies have shown that hepatic arterial infusion（HAI） therapy with floxuridine combined with systemic chemotherapy increases response rates and liver resection rates in those patients with initially unresectable CLM.All conversion strategies should be decided by a multidisciplinary team.