Poulou Loukia S, Ziakas Panayiotis D, Xila Vassilia, Vakrinos George, Malagari Katerina, Syrigos Konstantinos N, Thanos Loukas
Department of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases Sotiria, Mesogeion Av. 152, Athens 11527, Greece.
Rev Recent Clin Trials. 2009 Sep;4(3):140-6. doi: 10.2174/157488709789957592.
Despite the advent of combination chemotherapy regimens achieved within the last decade, long term survival of patients with unresectable metastatic disease from colorectal cancer remains poor. Thermal ablation procedures, including radiofrequency ablation (RFA), are considered feasible options in treating unresectable hepatic tumors either primary (hepatocellular carcinoma) or metastatic, the latter mainly arising from colorectal cancer. Percutaneous access is the least invasive RFA procedure.
METHODS & RESULTS: A MEDLINE review unfolded a significant clinical heterogeneity among published series reporting on percutaneous RFA in hepatic metastatic disease from colorectal cancer, regarding study population, optimal time and treatment schemes pre- and post-RFA intervention. Notwithstanding, percutaneous RFA survival figures were consistently better than front line chemotherapy. Furthermore, a pooled analysis of larger series demonstrated a clear benefit in overall survival (HR 0.51, 95% CI 0.44 to 0.58).
Albeit optimal indications are still pending, percutaneous RFA should nonetheless be considered a viable option in patients with unresectable metastatic disease, as it may prolong survival rates achieved with standard chemotherapy.
尽管在过去十年中出现了联合化疗方案，但无法切除的结直肠癌转移性疾病患者的长期生存率仍然很低。热消融手术，包括射频消融（RFA），被认为是治疗无法切除的原发性（肝细胞癌）或转移性肝肿瘤的可行选择，后者主要源于结直肠癌。经皮穿刺是侵入性最小的RFA手术。
一项MEDLINE综述显示，在已发表的关于结直肠癌肝转移疾病经皮RFA的系列报道中，在研究人群、RFA干预前后的最佳时间和治疗方案方面存在显著的临床异质性。尽管如此，经皮RFA的生存数据始终优于一线化疗。此外，对更大系列的汇总分析表明，在总生存期方面有明显益处（HR 0.51，95%CI 0.44至0.58）。
尽管最佳适应症仍未确定，但经皮RFA仍应被视为无法切除的转移性疾病患者的可行选择，因为它可能延长标准化疗所达到的生存率。
