Kallini Joseph R, Gabr Ahmed, Abouchaleh Nadine, Ali Rehan, Riaz Ahsun, Lewandowski Robert J, Salem Riad
From the *Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center; †Department of Surgery, Division of Transplantation, Comprehensive Transplant Center; and ‡Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL.
Cancer J. 2016 Nov-Dec;22(6):373-380. doi: 10.1097/PPO.0000000000000226.
Colorectal cancer is the third leading cause of cancer death in the United States. Although hepatic excision is the first-line treatment for colorectal liver metastasis (CRLM), few patients are candidates. Locoregional therapy (LRT) encompasses minimally invasive techniques practiced by interventional radiology. These include ablative treatments (radiofrequency ablation, microwave ablation, and cryosurgical ablation) and transcatheter intra-arterial therapy (hepatic arterial infusion chemotherapy, transarterial "bland" embolization, transarterial chemoembolization, and radioembolization with yttrium 90). The National Comprehensive Cancer Network recommends LRT for unresectable CRLM refractory to chemotherapy. The following is a review of LRT in CRLM, including salient features, advantages, limitations, current roles, and future considerations.
结直肠癌是美国癌症死亡的第三大主要原因。尽管肝切除术是结直肠癌肝转移(CRLM)的一线治疗方法,但适合的患者很少。局部区域治疗(LRT)包括介入放射学所采用的微创技术。这些技术包括消融治疗(射频消融、微波消融和冷冻手术消融)以及经导管动脉内治疗(肝动脉灌注化疗、经动脉“单纯”栓塞、经动脉化疗栓塞和钇90放射性栓塞)。美国国立综合癌症网络推荐对化疗难治的不可切除CRLM采用LRT。以下是对CRLM中LRT的综述,包括显著特点、优势、局限性、当前作用和未来考量。