Kemeny Nancy
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Oncology (Williston Park). 2006 Sep;20(10):1161-76, 1179; discussion 1179-80, 1185-6.
The liver is a frequent site of metastatic colorectal disease. Over the past 20 years, improvements in systemic chemotherapy and surgical techniques have improved the survival of patients with hepatic metastases. For 4 decades, fluorouracil and leucovorin were the only drugs available to treat metastatic colorectal cancer, but several new drugs and a variety of novel regimens are now available. Further improvements in results have been seen with the delivery of chemotherapy via the hepatic artery. Surgical resection of liver metastases has been encouraged when possible, and recent advances in surgery such as portal vein embolization, have made liver resection a possibility for more patients. This review considers the timing and sequence of chemotherapy and surgery in this setting, as well as the roles of cryoablation, radiofrequency ablation, and radiation therapy.
肝脏是结直肠癌转移的常见部位。在过去20年中，全身化疗和手术技术的进步提高了肝转移患者的生存率。四十年来，氟尿嘧啶和亚叶酸是仅有的可用于治疗转移性结直肠癌的药物，但现在有了几种新药和多种新方案。通过肝动脉进行化疗取得了进一步的疗效改善。在可能的情况下，鼓励对肝转移灶进行手术切除，而诸如门静脉栓塞等手术方面的最新进展，使更多患者能够接受肝切除手术。本文综述了这种情况下化疗和手术的时机及顺序，以及冷冻消融、射频消融和放射治疗的作用。
