初始可切除结直肠癌肝转移新辅助化疗的再思考  

Rethinking of neoadjuvant therapy for patients with initially resectable colorectal cancer liver metastases

作　　者：陈功[1] 李宇红[2] 张荣欣[1] 李斌奎[3] 王福龙[1] 元云飞[3] 潘志忠[1] 万德森[1] Chen Gong;Li Yuhong;Zhang Rongxin;Li Binkui;Wang Fulong;Yuan Yunfei;Pan Zhizhong;Wan Desen(Department of Colorectal Surgery,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China;Department of Medical Oncology,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China;Department of Hepatobiliary Surgery,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤医院结直肠科,广州510060 [2]中山大学肿瘤医院肿瘤内科,广州510060 [3]中山大学肿瘤医院肝胆外科,广州510060

出　　处：《中华肝胆外科杂志》2020年第7期488-492,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：手术切除是结直肠癌肝转移患者获得长期生存的主要手段,但是术后复发率较高。对于可切除肝转移病灶,术前新辅助化疗可以缩小肿瘤,判断肿瘤生物学行为,降低术后复发;但是也可能会引起肝损伤,延误手术。目前对于可切除结直肠癌肝转移是否应该行新辅助化疗,以及如何筛选新辅助化疗的获益患者,仍然存在争议。本文将结合近年来的研究进展,以及笔者所在中心的临床实践,从结直肠癌肝转移新辅助化疗的发展、新辅助化疗适应证的指南推荐、新辅助化疗方案的选择、新辅助化疗的常见问题四个方面,对可切除结直肠癌肝转移新辅助化疗的认识和思考进行详细阐述。Surgical resection is the best method for patients with colorectal cancer liver metastases.However,tumor recurrence rate is still high after surgery.Preoperative chemotherapy can help shrink the tumor,test biological behavior,and reduce recurrence rate;but it may also cause liver injury and delay surgery.There is still controversy whether neoadjuvant chemotherapy should be performed and how to select patients from chemotherapy before surgery.Thus,in this article,combined the research progress and the clinical experience of author's center,we discuss this issue in 4 aspects:the development of neoadjuvant chemotherapy;the indications and guideline recommendation for neoadjuvant chemotherapy;the selection of neoadjuvant chemotherapy regimens;common problems in neoadjuvant chemotherapy.

关 键 词：结直肠肿瘤 肝转移 化疗 外科手术 

分 类 号：R735.34[医药卫生—肿瘤]