Liu Jian-Yu, Liang Zhi-Hui, Liu Jing-Lei, Li Liang, Cui Bao, Li Tie-Gang
Department of Interventional Treatment, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, Hebei Province, China.
Department of Oncology, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, Hebei Province, China.
World J Gastrointest Surg. 2025 Aug 27;17(8):104568. doi: 10.4240/wjgs.v17.i8.104568.
Colorectal cancer (CRC) with liver metastasis remains a significant therapeutic challenge, particularly in cases of postoperative recurrence. While transarterial chemoembolization (TACE) and targeted therapies have shown promise individually, the efficacy combining these for treating postoperative recurrent CRC with liver metastasis requires further investigation.
To evaluate the efficacy and safety of TACE combined with targeted therapies for postoperative recurrent CRC with liver metastasis.
This observational study enrolled 75 patients with postoperative recurrent CRC accompanied by liver metastasis between January 2020 and December 2023. All patients received combined treatment with TACE and targeted therapy: Bevacizumab (40 patients, 53.3%), cetuximab (25 patients, 33.3%), or panitumumab (10 patients, 13.3%). Treatment response was evaluated using the Response Evaluation Criteria in Solid Tumors 1.1 criteria, with overall survival (OS) and progression-free survival as the primary endpoints. Quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire at baseline and after six months of treatment.
The median OS was 28 months (95% confidence interval: 24-32 months), and the median progression-free survival was 12 months (95% confidence interval: 10-14 months). Patients treated with bevacizumab showed significantly better survival outcomes than those treated with cetuximab/panitumumab (median OS, 30 24 months, = 0.015). The overall response rate was 58.7%, with a disease control rate of 86.7%. Quality of life scores improved significantly across all domains, with greater improvements observed in the bevacizumab group. Treatment-related adverse events were manageable, with grade 3-4 events occurring in 13.3% of the patients and no treatment-related mortality.
The combination of TACE with targeted therapy, particularly bevacizumab, has demonstrated promising efficacy and acceptable safety for the treatment of postoperative recurrent CRC with liver metastasis. This multimodal approach not only improved survival outcomes but also enhanced the patients' quality of life, suggesting its potential as a valuable treatment strategy for this challenging condition.
伴有肝转移的结直肠癌（CRC）仍然是一个重大的治疗挑战，尤其是在术后复发的情况下。虽然经动脉化疗栓塞术（TACE）和靶向治疗各自已显示出前景，但联合使用这些方法治疗术后复发的伴有肝转移的结直肠癌的疗效需要进一步研究。
评估TACE联合靶向治疗对术后复发的伴有肝转移的结直肠癌的疗效和安全性。
这项观察性研究纳入了2020年1月至2023年12月期间75例术后复发且伴有肝转移的结直肠癌患者。所有患者均接受了TACE和靶向治疗的联合治疗：贝伐单抗（40例患者，53.3%）、西妥昔单抗（25例患者，33.3%）或帕尼单抗（10例患者，13.3%）。使用实体瘤疗效评价标准1.1版标准评估治疗反应，以总生存期（OS）和无进展生存期作为主要终点。在基线和治疗6个月后，使用欧洲癌症研究与治疗组织生活质量问卷评估生活质量。
中位总生存期为28个月（95%置信区间：24 - 32个月），中位无进展生存期为12个月（95%置信区间：10 - 14个月）。接受贝伐单抗治疗的患者的生存结果明显优于接受西妥昔单抗/帕尼单抗治疗的患者（中位总生存期，30对24个月，P = 0.015）。总缓解率为58.7%，疾病控制率为86.7%。所有领域的生活质量评分均显著改善，贝伐单抗组的改善更为明显。治疗相关不良事件可控，3 - 4级事件发生在13.3%的患者中，无治疗相关死亡。
TACE联合靶向治疗，尤其是贝伐单抗，已显示出对治疗术后复发的伴有肝转移的结直肠癌有良好疗效且安全性可接受。这种多模式方法不仅改善了生存结果，还提高了患者的生活质量，表明其作为这种具有挑战性疾病的一种有价值治疗策略的潜力。
