结直肠癌肝转移的治疗策略(4)

肝动脉化疗原理

Adjuvant Therapy After Liver Resection：HAI + SYS versus SYS

	动脉+静脉	静脉	P=
两年生存率	85%	69%	0.02

Kemeny NE. N Engl J Med. 2005;352(7):734-735

Randomized Studies After Liver Resection HAI vs SYS or Control：Hepatic Disease-Free Survival

*No treatment in control arm

Randomized Studies After Liver Resection HAI vs SYS or Control：Disease-Free Survival

*No treatment in control arm

Modern Systemic Therapy as Adjuvant Therapy after Liver Resection


Between 2001-2005: 125 pts underwent resection of liver mets followed by HAI FUDR +SYS, compared to 125 consecutive pts who received Adj Folfox or Folfiri

House M, et al, Ann Surg, 2011, 851-6

HAI+ SYS- Overall Survival by Protocol

Survival (OS) by KRAS: Liver Resected Patients

MSKCC：Adjuvant HAI+SYS	MD Anderson：Adjuvant Sys

*Kemeny N. J Clin Oncol 30: 2013；**Vauthey JN. Ann Surg. 2013;258(4): 619-27

关于放射性微粒栓塞的共识


	Radioembolization Brachytherapy Oncology Consortium Int J Radiat Onc 2007

三、结肠癌肝转移新辅助治疗

新辅助化疗是对可切除的肝转移病灶术前化疗。

1. Kopetz S, Chang GJ, Overman MJ, Eng C, Sargent DJ, Larson DW, Grothey A, Vauthey JN, Nagorney DM, McWilliams RR. Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009 Aug 1;27(22):3677-83. doi: 10.1200/JCO.2008.20.5278. Epub 2009 May 26.

2. Peeters M, Price TJ, Cervantes A, Sobrero AF, Ducreux M, Hotko Y, André T, Chan E, Lordick F, Punt CJ, Strickland AH, Wilson G, Ciuleanu TE, Roman L, Van Cutsem E, Tzekova V, Collins S, Oliner KS, Rong A, Gansert J. Randomized phase III study of panitumumab with fluorouracil, leucovorin, and irinotecan (FOLFIRI) compared with FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer. J Clin Oncol. 2010 Nov 1;28(31):4706-13.

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