Department of Diagnostic Imaging and Oncologic Radiotherapy-Emergency and Interventional Radiology Unit, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00168 Rome, Italy.
Department of Diagnostic Imaging and Oncological Radiotherapy-Gemelli ART (Advanced Radiation Therapy), Interventional Oncology Center (IOC), Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00168 Rome, Italy.
Curr Oncol. 2024 Nov 20;31(11):7403-7413. doi: 10.3390/curroncol31110546.
The global incidence of secondary liver cancer is rising due to multiple risk factors, presenting significant challenges in public health. Similarly, colorectal cancer (CRC) remains a leading cause of cancer-related mortality with the development of frequent liver metastases. Surgical resection of CRC liver metastases is only suitable for a limited subset of patients, necessitating alternative nonsurgical treatments such as electrochemotherapy (ECT); Methods: This review adhered to the S.P.I.D.E.R.
Systematic searches of PubMed, Cochrane, and Scopus databases were conducted for studies published between 2003 and 2023, following PRISMA guidelines. Inclusion criteria were full-text clinical studies in English focusing on ECT-treated CRC liver metastases, excluding reviews, editorials, and non-clinical papers. The GRADE approach was utilized to assess evidence quality, considering study limitations, consistency, and other factors; Results: From 38 identified articles, 4 met the inclusion criteria, encompassing 78 patients and 128 treated lesions. The studies demonstrated variability in design and follow-up duration (3-11 months). Complete response (CR) rates ranged from 33.3% to 63.0%, while progression disease (PD) rates were high, ranging from 23.0% to 55.6%. Median overall survival (OS) spanned 11.3 to 29.0 months. No severe ECT-related complications were reported.
ECT appears to be a safe and effective modality for the treatment of CRC liver metastases, especially for lesions unsuitable for other ablative techniques. Further prospective and randomized studies are essential to better define the role of ECT in managing CRC liver metastases and to compare its efficacy with other ablative methods.
由于多种风险因素的存在，继发性肝癌的全球发病率正在上升，这对公共卫生构成了重大挑战。同样，结直肠癌（CRC）仍然是癌症相关死亡的主要原因，其肝脏转移的发生率也很高。CRC 肝转移的手术切除仅适用于少数患者，需要替代的非手术治疗方法，如电化学疗法（ECT）；方法：本综述遵循 S.P.I.D.E.R. 框架：对 2003 年至 2023 年发表的研究进行了系统的 PubMed、Cochrane 和 Scopus 数据库检索，遵循 PRISMA 指南。纳入标准为英语的全文字临床研究，重点关注 ECT 治疗的 CRC 肝转移，不包括综述、社论和非临床论文。使用 GRADE 方法评估证据质量，考虑研究局限性、一致性和其他因素；结果：从 38 篇已识别的文章中，有 4 篇符合纳入标准，共纳入 78 名患者和 128 个治疗病灶。这些研究在设计和随访时间（3-11 个月）上存在差异。完全缓解（CR）率在 33.3%至 63.0%之间，而进展疾病（PD）率较高，在 23.0%至 55.6%之间。中位总生存期（OS）为 11.3 至 29.0 个月。未报告严重的 ECT 相关并发症。结论：ECT 似乎是治疗 CRC 肝转移的一种安全有效的方法，特别是对于不适合其他消融技术的病灶。进一步的前瞻性和随机研究对于更好地确定 ECT 在管理 CRC 肝转移中的作用以及比较其与其他消融方法的疗效至关重要。
