摘要
目的评价CapeOX方案新辅助化疗结合手术治疗对不可切除性结直肠癌肝转移患者的疗效及预后影响。方法对51例符合标准的不可切除性结直肠癌肝转移患者应用CapeOX方案新辅助化疗,每2个周期评估1次疗效,如可行治愈性切除则考虑手术,术后继续CapeOX方案化疗,记录化疗缓解及手术切除情况,手术并发症、术后复发及生存状态,原发病灶中表皮生长因子受体(EGFR)的表达情况。结果 51例患者术前接受1～8周化疗(中位数4周),化疗后缓解22例,缓解率为43.1%(22/51),15例行治愈性切除(29.4%),化疗无效者19例(37.2%),中位生存期为12个月;化疗后缓解或稳定但未接受肝切除的17例,中位生存期为19个月;15例治愈性手术切除者有5例出现并发症,无手术死亡,随访中位时间21个月,仅6例复发,其中4例死亡,其他均存活。EGFR的表达与病情进展有关。结论 CapeOX方案术前化疗可使不可切除的肝转移患者转为可手术切除,结合根治性切除手术治疗,可患者的生存期延长。
Objective To evaluate the effect of CapeOX（capecitabine-oxaliplatin） new adjacent chemotherapy and hepatectomy on the patients with colorectal cancer and unresectable liver metastases.Methods Fifty-one patients with liver metastases from colorectal cancer,which meeting defined criteria of unresectability.Frist,the patients received CapeOX new adjacent chemotherapy,and assessed every 2 weeks.Patients whose liver metastases became resectable after treatment with CapeOX were considered to undergo liver metastasectomy,and then continued on further treatment with CapeOX after surgery.The therapeutic effects,including surgical response,rate of hepatectomy,postoperative complications and recurrence,and survival state,were evaluated.The expression of epidermal growth factor receptor（EGFR） in the primary lesions of the patients was also analyzed.Results These 51 patients received CapeOX new adjacent chemotherapy for 1-8 weeks（median therapeutic time was 4 weeks）.In 22 patients（43.1%） the liver metastases responded to CapeOX treatment,and 15 of them（29.4%） underwent curative hepatectomy;19 patients（37.2%） had no response to CapeOX treatment,and their median survival time was 12 months;the remaining 17 patients with stable disease or partial responses did not undergo curative surgery,and their median survival time was 19 months.Five of 15 patients who underwent curative hepatectomy had various complications,but no postoperative mortality.At median follow-up of 21 months in the hepatectomy group,relapse and death occurred in 6 and 4 cases respectively.The expression of EGFR was associated with the progression of the metastatic colorectal cancer.Conclusions CapeOX new adjacent chemotherapy can convert the unresectable liver metastases to be resectable in some patients.The combination of CapeOX with radical excision may can improve the outcome in selected patients with metastatic colorectal cancer.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2011年第4期347-351,共5页
China Journal of General Surgery
关键词
结直肠肿瘤
肝转移
新辅助化疗
肝切除术
Colorectal Neoplasms
Liver Metastases
New Adjacent Chemotherapy
Hepatectomy
