医学
养生
新辅助治疗
转移
肿瘤科
远处转移
内科学
癌症
乳腺癌
作者
T. Y. Gong,M. Y. Yu,Mei-Jin Zhong
出处
期刊:PubMed
日期:2021-03-25
标识
DOI:10.3760/cma.j.cn.441530-20200213-00053
摘要
Surgery is recognized as the core treatment for colorectal liver metastasis (CRLM), while its recurrence rate remains relatively high, even for resectable CRLM. This hints that the efficacy of treatment involves not only technological factors of surgery, but also biological behavior of tumor. For resectable CRLM, neoadjuvant therapy is beneficial to eliminate the micro-metastasis, reduce postoperative recurrence rate, screen tumor biological behavior and improve prognosis. However, questions about which kind of CRLM patients fits for neoadjuvant therapy and what regimen should be used are still debatable. This paper reviews stratified management of resectable CRLM, choice of neoadjuvant regimen, especially the application value of targeted therapy, based on the latest guidelines and studies.外科手术是结直肠癌肝转移(CRLM)治疗的核心手段,但即使是初始可切除的CRLM,仍存在较高的术后复发率。究其原因,除了外科因素,肿瘤生物学行为层面的"可切除"更能预测治疗的有效性。对于初始可切除CRLM,新辅助治疗有利于消灭微转移、降低术后复发率、筛选肿瘤生物学行为、改善预后。但是,哪一类CRLM患者更适合接受新辅助治疗,其方案该如何选择等问题仍存在较多争议。本文将从初始可切除CRLM的分层管理、新辅助治疗的策略和方案选择,特别是联合靶向药物的价值等方面,结合最新指南和研究进展进行综述。.
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