老年结直肠癌肝转移的治疗

Management of Colorectal Cancer Liver Metastases in The Elderly

目的总结老年结直肠癌肝转移(CRCLM)治疗的现状,探讨老年CRCLM治疗的方法和原则。方法复习国内、外近年来有关老年CRCLM治疗的相关文献并作综述。结果结直肠癌是消化系统最常见的恶性肿瘤,而最常见的转移部位是肝脏。近年来,老年结直肠癌发病率逐渐升高。虽然同年轻患者比较,老年CRCLM患者的身体状态和生理机能较差,但只要选取合适的病例,同样可以获得与年轻患者相似的治疗效果。目前,对于可切除的CRCLM患者,惟一可能治愈的手段仍然是外科手术治疗;而化疗和分子靶向药物治疗的最新进展,也让更多的老年患者生存获益。对于不可切除的CRCLM病灶尚可结合其他肝脏导向的局部治疗方法,如局部化疗、消融治疗等。结论根据CRCLM的发病特点和老年患者的自身特点,采用多学科协作模式下的个体化治疗模式,可进一步提高老年CRCLM患者的综合治疗效果。

Objective To summarize the current status and the management of colorectal cancer liver metastases（CRCLM） in the elderly and to explore the therapeutic principles and methods.Methods Foreign and domestic literatrues on management of CRCLM were reviewed and analyzed.Results Colorectal cancer was still one of the most common malignancy and the most common site for metastasis was liver.In the past years,the incidence of colorectal cancer in the elderly was gradually going up.A similar outcome can be achieved for the appropriate elder metastasis patients compared to the young group,although they were in worse physical conditions.Surgical resection was still the only possible treatment for cure to the resectable CRCLM,chemotherapy and biological therapy were also valuable adjunct therapies.For unresectable liver metastases,alternative treatments were recommended,such as radiofrequency ablation and hepatic artery infusion,etc.Conclusion According to the characteristic of CRCLM and the physical features of the eldrly patients,a better outcome should be obtained through multiple-disciplinary individualized therapy.