结直肠癌肝转移综合治疗进展

Recent advances in the comprehensive treatment of colorectal liver metastases

虽然手术仍是目前唯一有可能治愈结直肠癌肝转移的手段,但是在结直肠癌肝转移的诊疗方面发展迅速。多学科团队综合治疗和分组治疗逐渐成为诊疗规范。对可切除的结直肠癌肝转移患者,在围手术期也应实施标准化疗,是否加用靶向药物尚无定论。实施转化性化疗时应选择高效化疗方案,并尽量缩短疗程,且一旦转移灶转化为可切除,就应积极安排手术。肝转移灶不可切除的患者,是否切除原发灶也存在争议。在肝转移灶局部治疗方面的新技术发展迅速,可改善患者生存。

Although surgery is the only potentially curative method for colorectal liver metastases (CRLM),there are many advances in the treatments of CRLM .Multidisciplinary team and group therapy have become the standard treatments of CRLM .For patients with resectable CRLM , perioperative standard chemotherapy is necessary .However , whether the targeted therapy is needed to combined with is still inconclusive .Efficient chemotherapy regimen with short courses should be chosen for convertible therapy .And these patients should be operated as soon as the metastases become resectable .Resection of the primary tumor remains controversial in asymptomatic patients with unresectable CRLM .Some new locoregional therapies are developing fast to improve the survival .