结直肠癌肝转移综合治疗现状PPT.ppt

* 5-FU, 5-fluorouracil; DFS, disease-free survival; LV, leucovorin; R, randomization. The AURC 9002 study was a recent European trial that evaluated adjuvant therapy in patients with resectable liver metastases. Eligible patients were randomly assigned to receive either surgery alone or surgery followed by 6 cycles of 5?fluorouracil (5-FU) and leucovorin, using the Mayo Clinic approach. Of the 171 patients who enrolled in the trial, 95% had 3 or fewer liver metastases, indicating that these patients had lower risk disease. The primary outcome measure in this trial was disease-free survival (DFS). DFS, disease-free survival. Results of this trial showed a statistically significant 7?month gain in median DFS among patients who received chemotherapy compared with those who received surgery alone (median DFS: 24.4 vs 17.6 months, respectively; P = .028). 另外一个研究是分析切除率和有效率正相关性的关系，尤其在肝转移的CRC患者，正相关性的趋势尤其明显，得到结论，如果这个CRC的病人只有肝脏的转移灶，联合爱，有机会得到高有效率和切除率，和治愈的可能，预后将是全部病人中最好的。- Folprecht et al also reported that response to chemotherapy correlates with resection rate. - They reported a strong and highly significant corrrelation between the rates of liver resection and the tumor response to chemotherapy in selected patients (ie those with liver metastases only). - The correlation was still apparent, but less marked, in studies of non-selected patients. - A similar correlation was observed when phase lll trials including all patients were analyzed separately (p=0.024). 1. Folprecht G, Grothey A, Alberts S, et al. Ann Oncol 2005;16(8):1311-1319 Permission to include this figure in this CCO activity was granted by Eric Van Cutsem, MD, PhD. Permission to include this figure in this CCO activity was granted by Eric Van Cutsem, MD, PhD. She has responded so well why operate her at all? The answer is here Neoadjuvant chemotherapy also has its toxicity to the remnant liver ,it could increase the risk of surgery and even preclude liver resection. Two main types of chemotherapy – associat