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通过全身疗法和热废除来对抗结直肠肺转移:RAS突变的影响

Hongjie Fan^1,2,3, Tao Xu^1,2,3, Yulan Zeng⁴

¹Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

International journal of surgery (London, England)

|February 24, 2026

概括

拉斯突变预测结直肠肺转移治疗图像导向热移除 (IGTA) 的结果更差. KRAS突变与较差的局部控制和生存有关,特定的化疗方案在突变患者中显示出更好的整体存活率.

科学领域:

在瘤学瘤学.
干预性放射学干预性放射学
分子诊断学分子诊断

背景情况:

结直肠肺转移 (CRLM) 是一个重大的临床挑战.
图像导向热除 (IGTA) 是CRLM的一种治疗选择.
用IGTA治疗的CRLM中RAS突变的预后作用需要进一步调查.

研究的目的:

在接受IGTA的CRLM患者中确定RAS突变状态和亚型的预后价值.
在这个患者队列中,根据不同的全身疗法方案评估生存结果.

主要方法:

一项多中心回顾前性队列研究包括387名用IGTA治疗的CRLM患者.
患者按RAS基因型分层 (KRAS/NRAS野生型与突变型).
使用考克斯回归分析了生存结果 (LTPFS,PFS,OS),并对全身疗法进行了子组分析.

主要成果:

KRAS突变与较高的3年局部瘤进展 (LTP) 率 (25.0%与15.0%) 相关,并预测了较低的无进展生存率 (PFS).
与野生型相比,KRAS (17.9个月) 和NRAS突变患者 (22.1个月) 的平均整体存活时间 (OS) 显著减少.
在KRAS突变患者中,FOLFOX加贝瓦西祖马布比塞图西马布改善了生存状况.

结论:

RAS突变是CRLMIGTA后局部控制和生存不佳的独立预测因素.
进一步的研究应该探索RAS基因型和向药物之间的相互作用,在临废环境中.
这些发现支持基因型导向的废弃计划和CRLM的周边废弃性全身治疗策略.

关键词:

拉斯拉斯拉斯拉斯拉斯拉斯拉斯拉斯拉斯化学疗法化疗化疗大肠直肠肺转移.图像引导的热除是指导的.有针对性的治疗.

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