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局限性肝或肺结直肠癌转移。全身治疗、手术、消融或立体定向体部放疗。

Limited Liver or Lung Colorectal Cancer Metastases. Systemic Treatment, Surgery, Ablation or SBRT.

作者信息

Molla Meritxell, Fernandez-Plana Julen, Albiol Santiago, Fondevila Constantino, Vollmer Ivan, Cases Carla, Garcia-Criado Angeles, Capdevila Jaume, Conill Carles, Fundora Yliam, Fernandez-Martos Carlos, Pineda Estela

机构信息

Department of Radiation Oncology, Hospital Clinic Barcelona, Barcelona 08036, Spain.

Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona 08036, Spain.

出版信息

J Clin Med. 2021 May 14;10(10):2131. doi: 10.3390/jcm10102131.

Abstract

The prognosis for oligometastatic colorectal cancer has improved in recent years, mostly because of recent advances in new techniques and approaches to the treatment of oligometastases, including new surgical procedures, better systemic treatments, percutaneous ablation, and stereotactic body radiation therapy (SBRT). There are several factors to consider when deciding on the better approach for each patient: tumor factors (metachronous or synchronous metastases, RAS mutation, BRAF mutation, disease-free interval, size and number of metastases), patient factors (age, frailty, comorbidities, patient preferences), and physicians' factors (local expertise). These advances have presented major challenges and opportunities for oncologic multidisciplinary teams to treat patients with limited liver and lung metastases from colorectal cancer with a curative intention. In this review, we describe the different treatment options in patients with limited liver and lung metastases from colorectal cancer, and the possible combination of three approaches: systemic treatment, surgery, and local ablative treatments.

摘要

近年来,寡转移性结直肠癌的预后有所改善,这主要得益于寡转移灶治疗新技术和新方法的进展,包括新的手术方式、更好的全身治疗、经皮消融以及立体定向体部放疗(SBRT)。在为每位患者确定更佳治疗方法时,有几个因素需要考虑:肿瘤因素(异时性或同时性转移、RAS突变、BRAF突变、无病间期、转移灶的大小和数量)、患者因素(年龄、虚弱程度、合并症、患者偏好)以及医生因素(当地专业知识)。这些进展给肿瘤多学科团队带来了重大挑战和机遇,以便他们能够以治愈为目的治疗患有局限性肝肺转移的结直肠癌患者。在这篇综述中,我们描述了结直肠癌肝肺局限性转移患者的不同治疗选择,以及全身治疗、手术和局部消融治疗三种方法的可能组合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77cb/8157146/bb4406a6deff/jcm-10-02131-g001.jpg

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