Zhang Qi, Teng Gaojun
Interventional Radiology and Vascular Surgery, ZhongDa Hospital, Nanjing 210009, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Jun 25;20(6):621-624.
Colorectal liver metastasis (CRLM) is one of the most difficult and key points in the treatment of colorectal cancer. Approximately 50% to 60% of patients diagnosed as colorectal cancer develops metastasis, and 80% to 90% of CRLM is unresectable. Surgical resection is the first-line treatment for CRLM, while it is only suitable for about 15% patients. Systemic chemotherapy can prolong the survival of CRLM patients, however, a part of CRLM patients are resistant to chemotherapy. With the development of technology and the update of clinical evidence, individual therapy with target drugs and multidisciplinary treatment (MDT) have became a tendency, and minimally invasive interventional therapy has gained more acceptance in the MDT mode of the treatment for CRLM. Basically, the interventional treatment for CRLM is divided into two groups: vascular intervention and local minimally invasive intervention. Vascular approaches encompass portal vein embolization (PVE), hepatic artery infusion chemotherapy (HAIC), transarterial chemoembo- lization (TACE), and transarterial radioembolization (TARE). Local minimally invasive intervention includes radiofrequency ablation (RFA), microwave ablation(MWA), cryoablation (CRA), and irreversible electroporation (IRE). Thevefore intervention treatment is an important complement to the comprehensive therapy of CRLM.
结直肠癌肝转移（CRLM）是结直肠癌治疗中最困难的关键点之一。约50%至60%被诊断为结直肠癌的患者会发生转移，而80%至90%的CRLM不可切除。手术切除是CRLM的一线治疗方法，但仅适用于约15%的患者。全身化疗可延长CRLM患者的生存期，然而，一部分CRLM患者对化疗耐药。随着技术的发展和临床证据的更新，靶向药物个体化治疗和多学科治疗（MDT）已成为一种趋势，微创介入治疗在CRLM治疗的MDT模式中获得了更多认可。基本上，CRLM的介入治疗分为两组：血管介入和局部微创介入。血管介入方法包括门静脉栓塞（PVE）、肝动脉灌注化疗（HAIC）、经动脉化疗栓塞（TACE）和经动脉放射性栓塞（TARE）。局部微创介入包括射频消融（RFA）、微波消融（MWA）、冷冻消融（CRA）和不可逆电穿孔（IRE）。因此，介入治疗是CRLM综合治疗的重要补充。
