EUR J Cancer:FOLFOXIRI联合贝伐单抗治疗肝脏转移性结直肠癌的必要性

2017-12-31 MedSci MedSci原创

对于转移性结直肠癌患者的治疗,转移灶(大部分在肝脏,也有在肺部)的切除代表了一种潜在的治愈方式。虽然目前仍没有前瞻性随机试验对转移灶切除的价值进行评估,且许多患者经历了复发,但继发性转移瘤切除术已经被广泛接受。综合这些发展,加上积极的全身治疗,即使对于肝脏转移性的结直肠癌患者,医生也能做出转移灶切除的选择。

对于转移性结直肠癌患者的治疗,转移灶(大部分在肝脏,也有在肺部)的切除代表了一种潜在的治愈方式。虽然目前仍没有前瞻性随机试验对转移灶切除的价值进行评估,且许多患者经历了复发,但继发性转移瘤切除术已经被广泛接受。综合这些发展,加上积极的全身治疗,即使对于肝脏转移性的结直肠癌患者,医生也能做出转移灶切除的选择。

更重要的是,可明显切除的肝脏病变和经全身治疗后变成可明显切除的肝脏病变的结果是相似的,但需要不同的治疗策略。结直肠癌的肝脏转移灶是可明显切除的,或者经化疗方法(FOLFOX5-氟尿嘧啶,亚叶酸,奥沙利铂)处理后可明显切除的。在无法预先切除的肝脏限制的转移性结直肠癌患者中,转化治疗同样可以缩小肿瘤组织的体积,但这些疗法应当至少包含两种细胞毒性药物(FOLFOXFOLFIRI:氟尿嘧啶,亚叶酸,伊立替康,FOLFOXIRI5-氟尿嘧啶,亚叶酸,奥沙利铂,伊立替康)。但是由于病灶的转移,那些患者可能无法再进行手术治疗。 

原始出处:

Modest, D. P., U. P. Neumann, and J. Pratschke. "FOLFOXIRI plus bevacizumab as conversion-therapy for liver metastases in colorectal cancer: A necessity?." European Journal of Cancer 2017 73: 71-73. doi.org/10.1016/j.ejca.

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