Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Ther Adv Med Oncol. 2013 Jul;5(4):221-34. doi: 10.1177/1758834013485111.
Colorectal cancer is the third most common cancer in the Western population and has a 5-year overall survival of 5-10% when metastatic. Approximately 30% of the patients with metastatic colorectal cancer have limited disease apparently isolated to the liver and, if this can be resected, the 5-year overall survival is improved to 30-60%. Therefore, it is important to identify patients who have both resectable disease and those with initially unresectable tumors who can potentially be downsized with chemotherapy to allow resection. First-line doublet chemotherapy regimens lead to response rates of 50-60%, triplet chemotherapy regimens may result in a response rate of up to 70%, and biological agents may add to responses or induce morphologic changes that facilitate disease resection. Surgical advances in recent years have also increased resectability rates and have challenged prior rules of resectability. Local therapies including ablation and radiation, often performed in conjunction with resection, may further aid in control of disease. The aim of this article is to focus on the role of neoadjuvant therapy in the treatment of colorectal liver metastases.
结直肠癌是西方人群中第三大常见癌症，当转移时，其 5 年总生存率为 5-10%。大约 30%的转移性结直肠癌患者的疾病明显局限于肝脏，如果可以切除，5 年总生存率可提高至 30-60%。因此，重要的是要识别出既有可切除疾病的患者，也有最初不可切除的肿瘤患者，这些患者可能通过化疗缩小肿瘤从而实现切除。一线双联化疗方案的缓解率为 50-60%，三联化疗方案的缓解率可能高达 70%，而生物制剂可能会增加缓解率或诱导形态学变化，从而有利于疾病的切除。近年来外科手术的进步也提高了可切除性，对先前的可切除性规则提出了挑战。局部治疗（包括消融和放疗），通常与切除术联合进行，可能进一步有助于控制疾病。本文的目的是重点关注新辅助治疗在结直肠肝转移治疗中的作用。
