结直肠癌肝转移新辅助治疗研究进展及挑战

Advances and challenges in neoadjuvant treatment for colorectal cancer liver metastasis

肝转移是结直肠癌患者死亡的主要原因。单纯手术治疗具有较高的术后复发率。新辅助治疗作为一种降低患者复发、改善生存的重要手段被越来越多的研究采用。目前,结直肠癌肝转移的新辅助治疗在获益人群的探索、化疗方案的选择以及疗程的确定等诸多方面均取得了一定的进展。但在可切除标准的判断、靶向药物等的应用方面,仍存在一些争议。临床医生可在多学科团队协作基础上制定治疗策略,针对具体患者,做出个体化不同强度的治疗方案,达到"整合资源,分层施治"的目标。

Liver metastasis is the leading cause of death in patients with colorectal cancer.Since surgical resection alone has a high postoperative recurrence rate,neoadjuvant therapy as an important means is widely applied in order to reduce recurrence and improve survival.Progress has been achieved in many aspects of neoadjuvant therapy in colorectal cancer liver metastasis,such as eligible patients selection,optimal regimens and courses of chemotherapy.However,controversies still remain regarding the standards of resectability of lesions and the application of targeted drugs.Individualized treatments could be developed based on multidisciplinary teamwork to achieve the goal of'resources integration and treatment stratification'.