针对结肠直肠癌的肝脏导向治疗:我们现在在哪里?
Yi Song1, Meenakshi Jeeva2,3, Robert P Liddell4
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
概括
对于具有肝转移的结直肠癌 (CRLM),手术切除是理想的,但并不总是可能的. 以肝脏为导向的疗法为无法切除的疾病提供了关键的局部区域治疗选择,改善了生存率.
科学领域:
- 在瘤学瘤学.
- 肝病学 肝病学是一种肝病学.
- 手术瘤学手术瘤学
背景情况:
- 大肠直肠癌经常转移到肝脏,25%的患者被诊断出肝脏转移,50%的患者随着时间的推移而发展.
- 手术切除是肝转移的黄金标准,但许多结直肠肝转移 (CRLM) 患者无法接受前置手术.
研究的目的:
- 对无法切除的结直肠肝转移 (uCRLM) 的肝脏导向治疗的范围进行审查.
- 讨论UCRLM.的局部区域治疗的结果和正在进行的发展.
主要方法:
- 对UCRLM的肝脏导向疗法的当前文献的综述.
- 讨论多学科方法,将系统治疗与局部治疗相结合.
- 评估各种地方区域的选择,包括肝动脉输液,SBRT,切除和跨动脉疗法.
主要成果:
- 对于CRLM的长期存活率受到肝脏导向治疗的显著影响,即使有系统化疗的进步.
- 对于uCRLM存在几个地方区域的选择,包括肝动脉输液疗法,SBRT,切除和跨动脉化学栓塞/放射栓塞.
- 新出现的证据支持选择uCRLM的患者进行肝移植.
结论:
- 为了管理CRLM,必须采取多学科的方法,将治疗量身定制为个别患者的目标.
- 针对肝脏的各种疗法为无法切除的CRLM患者提供了有价值的选择,影响了生存结果.
- 目前正在进行的研究和不断发展的技术继续扩大CRLM的治疗领域.
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