中华结直肠疾病电子杂志
中華結直腸疾病電子雜誌
중화결직장질병전자잡지
Chinese Journal of Colorectal Diseases
2014年
1期
5-8
,共4页
结直肠癌肝转移%多学科团队%围手术期化疗%转化性治疗%局部治疗
結直腸癌肝轉移%多學科糰隊%圍手術期化療%轉化性治療%跼部治療
결직장암간전이%다학과단대%위수술기화료%전화성치료%국부치료
Colorectal liver metastases%Multidisciplinary team%Perioperative chemotherapy%Convertible therapy%Locoregional therapy
虽然手术仍是目前唯一有可能治愈结直肠癌肝转移的手段，但是在结直肠癌肝转移的诊疗方面发展迅速。多学科团队综合治疗和分组治疗逐渐成为诊疗规范。对可切除的结直肠癌肝转移患者，在围手术期也应实施标准化疗，是否加用靶向药物尚无定论。实施转化性化疗时应选择高效化疗方案，并尽量缩短疗程，且一旦转移灶转化为可切除，就应积极安排手术。肝转移灶不可切除的患者，是否切除原发灶也存在争议。在肝转移灶局部治疗方面的新技术发展迅速，可改善患者生存。
雖然手術仍是目前唯一有可能治愈結直腸癌肝轉移的手段，但是在結直腸癌肝轉移的診療方麵髮展迅速。多學科糰隊綜閤治療和分組治療逐漸成為診療規範。對可切除的結直腸癌肝轉移患者，在圍手術期也應實施標準化療，是否加用靶嚮藥物尚無定論。實施轉化性化療時應選擇高效化療方案，併儘量縮短療程，且一旦轉移竈轉化為可切除，就應積極安排手術。肝轉移竈不可切除的患者，是否切除原髮竈也存在爭議。在肝轉移竈跼部治療方麵的新技術髮展迅速，可改善患者生存。
수연수술잉시목전유일유가능치유결직장암간전이적수단，단시재결직장암간전이적진료방면발전신속。다학과단대종합치료화분조치료축점성위진료규범。대가절제적결직장암간전이환자，재위수술기야응실시표준화료，시부가용파향약물상무정론。실시전화성화료시응선택고효화료방안，병진량축단료정，차일단전이조전화위가절제，취응적겁안배수술。간전이조불가절제적환자，시부절제원발조야존재쟁의。재간전이조국부치료방면적신기술발전신속，가개선환자생존。
Although surgery is the only potentially curative method for colorectal liver metastases (CRLM),there are many advances in the treatments of CRLM .Multidisciplinary team and group therapy have become the standard treatments of CRLM .For patients with resectable CRLM , perioperative standard chemotherapy is necessary .However , whether the targeted therapy is needed to combined with is still inconclusive .Efficient chemotherapy regimen with short courses should be chosen for convertible therapy .And these patients should be operated as soon as the metastases become resectable .Resection of the primary tumor remains controversial in asymptomatic patients with unresectable CRLM .Some new locoregional therapies are developing fast to improve the survival .
