伴有同时性不可切除肝转移的结直肠癌患者治疗的思考

对于肝转移灶不可切除的结直肠癌患者，需要经过多学科刚队讨论，采用全身化疗、介入化疗和肝转移灶消融毁损术等多种方法改善患者预后．应结合患各和肿瘤的特征将患者分为不同组刖，制定各自的治疗同标和治疗策略。其中部分患者，如果化疗后可能转化为潜在可切除，建议给予强化的三药联合方案，尽髓缩短疗程，从而获得肿瘤的最佳反应率．继而行手术切除。KRAS野乍型的患并推荐西妥子单抗联合FOLFOX或FOLFIRI方案，而且旦转移灶转化为可切除，就应该积极手术切除。埘十肝转移灶不可切除且原发灶尤症状的患者，手术切除原发灶似乎可以获得生存收益。关于非手术治疗的选择，目前临床上还存在争议。

Consideration of therapy for colorecta cancer with synchronous unresectable liver metastasis

A variety of managements, inluding systemi and loeal chemotherapy, radiofrequeney ablation and uther, are used after mnltidiseiplinary team discussion to improve the survival of patients with unreseetahle liver nlelaslasis, and to enlarge the eohorl of patients who van he managed with curative intent. Patients should be divided into differenl clinical groups aeeording to characteristics of the patient and tumor, and thenreeeive different treatments. For the patients who may be converted to be reseetable ffter chemotherapy, we should choose efficient eonvertible chemotherapy with short coupes to get the best response rate. For KRAS wild-type patients, eetuximah combined with FOLFOX/FOLFIRI, in which 5-fluorouraeil is continuously infused, is recommended. In addition, resection of the primary tumor is recommended at the right time for asymptomatie patients with unreseetahle liver metastases. There is no consensus on the preferred treatment modality for systemic anti local therapies.