Treatment of colorectal liver metastases.
Treatment of colorectal liver metastases.
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DOI：
10.1186/1477-7819-9-154
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发表时间：
2011-11-24
影响因子：
3.2
通讯作者：
Ismaili N
中科院分区：
文献类型：
--
作者：
Ismaili N
结直肠癌 (CRC) 是世界上第三大常见癌症。肝转移是结直肠转移最常见的部位。近年来，随着化疗和手术切除作为该疾病多学科治疗的一部分，可切除结直肠肝转移瘤（CRLM）的预后得到改善；目前肝转移瘤切除后5年生存率为25%至40%。可切除的同步或异时肝转移瘤应在术前三个月和术后三个月的 FOLFOX4（5-氟尿嘧啶 [5FU]、亚叶酸 [LV] 和奥沙利铂）化疗基础上进行围手术期化疗。在初次手术的情况下，应进行 6 个月的基于 5FU/LV、FOLFOX4、XELOX（卡培他滨和奥沙利铂）或 FOLFIRI（5FU/LV 和伊立替康）的伪辅助化疗。对于可能可切除的疾病，应考虑基于更强化治疗方案（例如 FOLFIRINOX（5FU/LV、伊立替康和奥沙利铂））的初次化疗，以提高治愈的机会。基于 FOLFIRI 或 FOLFOX4/XELOX 联合或不联合靶向治疗的姑息化疗是不可切除疾病的主要治疗方法。本综述将为 CRLM 管理中化疗和手术的最佳整合问题提供更多见解。
Colorectal cancer (CRC) is the third most common cancer in the word. Liver metastasis is the most common site of colorectal metastases. The prognosis of resectable colorectal liver metastases (CRLM) was improved in the recent years with the consideration of chemotherapy and surgical resection as part of the multidisciplinary management of the disease; the current 5-year survival rates after resection of liver metastases are 25% to 40%. Resectable synchronous or metachronous liver metastases should be treated with perioperative chemotherapy based on three months of FOLFOX4 (5-fluorouracil [5FU], folinic acid [LV], and oxaliplatin) chemotherapy before surgery and three months after surgery. In the case of primary surgery, pseudo-adjuvant chemotherapy for 6 months, based on 5FU/LV, FOLFOX4, XELOX (capecitabine and oxaliplatin) or FOLFIRI (5FU/LV and irinotecan), should be indicated. In potentially resectable disease, primary chemotherapy based on more intensive regimens such as FOLFIRINOX (5FU/LV, irinotecan and oxaliplatin) should be considered to enhance the chance of cure. The palliative chemotherapy based on FOLFIRI, or FOLFOX4/XELOX with or without targeted therapies, is the mainstay treatment of unresectable disease. This review would provide additional insight into the problem of optimal integration of chemotherapy and surgery in the management of CRLM.
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影响因子：
9
作者：
Fong, Y;Fortner, J;Blumgart, LH
通讯作者：
Blumgart, LH
影响因子：
45.3
作者：
Aloia, Thomas;Sebagh, Mylene;Adam, Rene
通讯作者：
Adam, Rene
影响因子：
39.2
作者：
Bellentani, S;Saccoccio, G;Tiribelli, C
通讯作者：
Tiribelli, C
影响因子：
158.5
作者：
Hurwitz, H;Fehrenbacher, L;Kabbinavar, F
通讯作者：
Kabbinavar, F
影响因子：
45.3
作者：
Grothey, A;Sargent, D;Schmoll, HJ
通讯作者：
Schmoll, HJ