初始可切除结直肠癌肝转移术后辅助化疗的研究进展

Research progress of adjuvant chemotherapy in the treatment of resectable colorectal liver metastases

结直肠癌是目前全球第三大常见的恶性肿瘤,大约有50%的患者在病程中发生肝转移。结直肠癌肝转移(CRLM)分为初始可切除和不可切除。肝切除术目前被认为是治疗CRLM唯一潜在的治愈方法,患者5年生存率约为37%~40%。但肝切除术后这部分患者仍然存在较高的复发风险,因此选择合适的辅助治疗尤为重要。目前CRLM患者术后辅助化疗存在争议,以往前瞻性临床研究发现术后辅助化疗能延长无进展生存时间,但无法改善总生存时间。最近部分研究在化疗基础上联合靶向药物或肝动脉灌注化疗(HAIC)等应用于术后CRLM患者,以期获得更好的疗效。本文就可切除CRLM术后辅助化疗的应用现状及研究进展作一综述。

Colorectal cancer(CRC)is the third most common malignancies in the world,and nearly 50%of patients with CRC will develop liver metastases during the course of the disease.Colorectal liver metastases(CRLM)is divided into initial resectable and unresectable.Hepatectomy is currently considered as the only potential cure for CRLM,and its 5-year survival rate is about 37%-40%.However,patients with CRLM still have a high risk of recurrence after hepatectomy,so it is particularly important to choose appropriate adjuvant treatment after hepatectomy.At present,postoperative adjuvant chemotherapy for patients with CRLM is controversial.Through prospective clinical research,it is found that postoperative adjuvant chemotherapy could prolong the disease-free survival,but could not improve overall survival.Some recent studies about combined targeted drugs or hepatic artery infusion chemotherapy(HAIC)based on chemotherapy is in an attempt to obtain better curative effect.This article reviews the application status and research progress of adjuvant chemotherapy in patients with resectable CRLM.