射频消融的联合治疗消融治疗的工具箱 修改自  RAPID FIRE case
50 Y/O male
2009:Sigmoid colon adenocarcinoma (RAS wild type) and right liver lobe liver mets:
2010; Perioperative ChemoT(12 cycles FOLFIRI+ Cetuximab)+ RLHepatectomy+ Sigmoidectomy RO
2011: Colon local recurrence: left hemicolectomy RO 2012: Liver progression: MWA+ FOLFIRI+ Cetuximab
 2013:Chemo toxicity: LV5FU2+ Cetuximab (24 cycles)2014: Chemo STOP (patient preference) SD
2014: Liver progression: 2nd MWA PR(8M)
2015: Liver progression: DEBIRI-TACE SD (6M)
2016: Y-90 TARE (radial outpatient) PD
2016: Liver progression: FOLFIRI+Cetuximab: dose reduction (Grade 2-3 CTAE v.4.0) (28 cycles) SD
2018:Biochemical and metabolic progression:3rd MWA+ FOLFIRI+ Cetuximab PR
2018: Partial response (w/o liver disease):ECOG-PS 0 until now
问题
还需要大的肝切除吗？Are major resections still needed ?
保留更多的肝是未来的趋势吗？Spare more liver is the future trend ?
联合区域治疗的局部治疗是否有益？或后续的结果会更好？Combining Local with Locoregional is useful? Or sequential is better?
化疗仍然是转移癌的金标准，但量身定制的辅助治疗正不断增加新的证据Chemo is still the gold standard in metastatic cancer but tailored adjuvant therapies are increasing evidence
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