Regional hepatic chemotherapies in the treatment of colorectal cancer metastases to the liver.
Regional hepatic chemotherapies in the treatment of colorectal cancer metastases to the liver.
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DOI：
10.1053/j.seminoncol.2010.03.005
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发表时间：
2010-04
影响因子：
4
通讯作者：
T. Pwint;R. Midgley;D. Kerr
中科院分区：
文献类型：
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作者：
T. Pwint;R. Midgley;D. Kerr
肝脏是结直肠癌（CRC）最常见的转移扩散部位。肝脏可能是多达30%至40%的晚期疾病患者的唯一扩散部位，可以通过针对肝脏肿瘤的区域治疗进行治疗。手术是目前唯一可能治愈的治疗方法，在选定的患者中，5年生存率高达30%至40%。然而，只有不到25%的病例是根治性切除的候选者。一些其他局部治疗，如射频或微波消融，冷冻治疗和化疗，可提供给患者不可切除，但孤立的肝转移。然而，对于大多数肝外转移的患者，全身化疗而不是区域治疗是更合适的选择。我们回顾了各种区域性肝化疗治疗结直肠癌肝转移的现状，根据现有的，已发表的前瞻性，随机试验，这门学科还没有适当地应用于新兴的局部消融技术的使用。审查的区域策略包括5-氟尿嘧啶（5-FU）门静脉输注（PVI）、动脉内化疗（肝动脉输注[HAI]）、化疗栓塞和选择性内部放射治疗（SIRT）。
The liver is the most common site of metastatic spread of colorectal cancer (CRC). Liver may be the only site of spread in as many as 30% to 40% of patients with advanced disease and can be treated with regional therapies directed toward their liver tumors. Surgery is currently the only potentially curative treatment, with a 5-year survival rate as high as 30% to 40% in selected patients. However, fewer than 25% of cases are candidates for curative resection. A number of other locoregional therapies, such as radiofrequency or microwave ablation, cryotherapy, and chemotherapy, may be offered to patients with unresectable but isolated liver metastases. However, for most patients with metastatic spread beyond the liver, systemic chemotherapy rather than regional therapy is a more appropriate option. We review the status of various regional hepatic chemotherapies in the treatment of colorectal metastases to the liver in the light of the available, published prospective, randomized trials; this discipline has not yet been properly applied to the burgeoning use of locally ablative techniques. The regional strategies reviewed include portal venous infusion (PVI) of 5-fluorouracil (5-FU), intra-arterial chemotherapy (hepatic arterial infusion [HAI]), chemoembolization, and selective internal radiation therapy (SIRT).