Sutphin Patrick D, Ganguli Suvranu
Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Division of Interventional Radiology, Department of Radiology, Boston Medical Center, Boston University Medical School, Boston, Massachusetts.
Semin Intervent Radiol. 2020 Dec;37(5):492-498. doi: 10.1055/s-0040-171919. Epub 2020 Dec 11.
Modern systemic therapies provide a significant survival benefit in metastatic colorectal cancer. Despite these advances, the durability of response remains limited and nearly all patients progress on systemic treatment. Colorectal liver metastases (CLM) develop in approximately half of patients with metastatic disease and contribute to mortality in most patients. In selected patients, surgical resection of hepatic metastases prolongs survival, indicating the benefits of the targeted treatment of CLM through alternate means. Minimally invasive interventional treatments offer the promise of treating CLM in a wider range of patients than those eligible for surgical resection. Thermal ablation and intra-arterial therapies, including chemoembolization and radioembolization, are commonly used in the treatment of CLM. Each of these treatment modalities will be discussed in detail with an emphasis on the available clinical data for each interventional treatment for CLM.
现代全身治疗在转移性结直肠癌中提供了显著的生存获益。尽管有这些进展，但反应的持久性仍然有限，几乎所有患者都会在全身治疗中出现疾病进展。约半数转移性疾病患者会发生结直肠肝转移（CLM），并且这是大多数患者死亡的原因。在部分患者中，肝转移灶的手术切除可延长生存期，这表明通过其他手段靶向治疗CLM具有益处。与适合手术切除的患者相比，微创介入治疗有望治疗更广泛的CLM患者。热消融和动脉内治疗，包括化疗栓塞和放射性栓塞，常用于CLM的治疗。将详细讨论这些治疗方式中的每一种，重点是CLM每种介入治疗的现有临床数据。
