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Use of Circulating Tumor DNA to Guide Decision-making in Adjuvant Colon Cancer. 利用循环肿瘤 DNA 指导结肠癌辅助治疗决策。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI: 10.1007/s11912-024-01565-y
Zachary Gottschalk, Stacey A Cohen

Purpose of review: The use of circulating tumor DNA (ctDNA) assays to guide clinical decision-making in early-stage colon cancer is an area of rapidly advancing active research. With assays clinically available, clinicians must be informed how to best use this novel tool to treat patients.

Recent findings: Recent observational and prospective studies have suggested that ctDNA has potential to guide clinical decision-making in early-stage colon cancer by detecting minimal residual disease (MRD) and predicting recurrence risks. MRD-negative patients may be able to de-escalate or forgo adjuvant chemotherapy (ACT) without compromising disease-free survival or overall survival, while MRD-positive patients may benefit significantly from ACT. Recent and ongoing studies have given reason for optimism about the future of ctDNA as a useful biomarker for clinicians treating early-stage colon cancer. Data thus far are mostly limited to observational studies; inconsistent results highlight the need for caution. As more evidence emerges, ctDNA may become standard of care for colon cancer patients.

综述目的:使用循环肿瘤 DNA (ctDNA) 检测来指导早期结肠癌的临床决策是一个快速发展的活跃研究领域。随着检测方法在临床上的应用,临床医生必须了解如何更好地利用这一新型工具来治疗患者:最近的观察性和前瞻性研究表明,ctDNA 有可能通过检测最小残留病(MRD)和预测复发风险来指导早期结肠癌的临床决策。MRD阴性患者可以降低或放弃辅助化疗(ACT),而不会影响无病生存期或总生存期,而MRD阳性患者则可能从辅助化疗中获益匪浅。最近和正在进行的研究使人们有理由对ctDNA作为临床医生治疗早期结肠癌的有用生物标志物的前景持乐观态度。迄今为止的数据大多局限于观察性研究;不一致的结果凸显了谨慎的必要性。随着更多证据的出现,ctDNA 可能会成为结肠癌患者的标准治疗方法。
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引用次数: 0
Immunological Checkpoint Blockade in Anal Squamous Cell Carcinoma: Dramatic Responses Tempered By Frequent Resistance. 肛门鳞状细胞癌的免疫检查点阻断疗法:频繁的抗药性抑制了剧烈的反应
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-11 DOI: 10.1007/s11912-024-01564-z
Thejus Jayakrishnan, Devvrat Yadav, Brandon M Huffman, James M Cleary

Purpose of review: Squamous cell carcinoma of the anus (SCCA) is an HPV-associated malignancy that has limited treatment options. Immunotherapy has expanded these options and here we review current and emerging immunotherapeutic approaches.

Recent findings: Multiple studies of single-agent anti-PD1/PD-L1 immunotherapy have demonstrated a modest response rate of approximately 10% to 15%. While a minority of patients (~5%) with SCCA experience durable complete responses, most advanced SCCAs are resistant to anti-PD1/PD-L1 monotherapy. Given the need for more broadly effective immunotherapies, novel strategies, such as adaptive cell therapies and therapeutic vaccination, are being explored. To reduce the recurrence risk of localized high-risk SCCA, strategies combining immunotherapy with chemoradiation are also being investigated. While a small subset of patients with SCCA have prolonged responses to PD1-directed immunotherapy, the majority do not derive clinical benefit, and new immunotherapeutic strategies are needed. Better understanding of the immune microenvironment and predictive biomarkers could accelerate therapeutic advances.

综述目的:肛门鳞状细胞癌(SCCA)是一种与 HPV 相关的恶性肿瘤,其治疗方案有限。免疫疗法扩大了这些选择的范围,在此我们回顾了当前和新兴的免疫治疗方法:单药抗PD1/PD-L1免疫疗法的多项研究显示,反应率不高,约为10%至15%。虽然少数 SCCA 患者(约 5%)获得了持久的完全应答,但大多数晚期 SCCA 患者对抗 PD1/PD-L1 单药治疗产生了耐药性。鉴于需要更广泛有效的免疫疗法,目前正在探索适应性细胞疗法和治疗性疫苗接种等新策略。为了降低局部高危SCCA的复发风险,免疫疗法与化疗放疗相结合的策略也在研究之中。虽然一小部分 SCCA 患者对 PD1 引导的免疫疗法有长期反应,但大多数患者并没有获得临床获益,因此需要新的免疫治疗策略。更好地了解免疫微环境和预测性生物标志物可加快治疗进展。
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引用次数: 0
Toxicities from BRAF and MEK Inhibitors: Strategies to Maximize Therapeutic Success. BRAF 和 MEK 抑制剂的毒性:最大限度提高治疗成功率的策略。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-08 DOI: 10.1007/s11912-024-01544-3
Mike Wang, Ryan J Sullivan, Meghan J Mooradian

Purpose of review: This report highlights several of the recent therapeutic advancements in the treatment of BRAF-mutant tumors, discusses the most common adverse events observed with BRAF-targeted agents, and suggests strategies to manage and mitigate treatment-related toxicities.

Recent findings: BRAF and MEK inhibitors represent a significant advancement in the treatment of BRAF-mutated malignancies with data across tumor types demonstrating the anti-tumor efficacy of dual MAPK inhibition. Although these agents have a reasonable toxicity profile, variable side effects across organ systems can develop. The discovery of activating BRAF mutations and subsequent development of BRAF and MEK inhibitors has transformed the treatment algorithms of BRAF-mutant malignancies. With increased application of these targeted regimens, identification and prompt management of their unique adverse events are crucial.

综述目的:本报告重点介绍了治疗BRAF突变肿瘤的几项最新治疗进展,讨论了BRAF靶向药物最常见的不良反应,并提出了管理和减轻治疗相关毒性的策略:BRAF和MEK抑制剂是治疗BRAF突变恶性肿瘤的重大进展,各种肿瘤类型的数据都证明了MAPK双重抑制的抗肿瘤疗效。虽然这些药物具有合理的毒性,但在不同器官系统中会产生不同的副作用。活化 BRAF 突变的发现以及随后 BRAF 和 MEK 抑制剂的开发改变了 BRAF 突变恶性肿瘤的治疗算法。随着这些靶向治疗方案应用的增加,识别并及时处理其独特的不良反应至关重要。
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引用次数: 0
Telehealth Utilization in Neuro-Oncology: Commentary on a Single Institution Experience After the COVID-19 Pandemic. 远程医疗在神经肿瘤学中的应用:COVID-19 大流行后的单个机构经验评述。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-31 DOI: 10.1007/s11912-024-01588-5
Ugur Sener, Joon Uhm, Tufia Haddad, Joshua Pritchett

Purpose: During the COVID-19 pandemic, regulatory and reimbursement policy changes provided patients improved access to neuro-oncology by telehealth. Here we discuss benefits and limitations of telehealth use in neuro-oncology. We review utilization of telemedicine services following the COVID-19 pandemic.

Recent findings: Utilization of telemedicine by neuro-oncology during the COVID-19 pandemic was 52%, compared to 27-29% for other solid tumors groups. Following the pandemic, between January 2021 and April 2024, telehealth utilization has remained high in neuro-oncology with approximately 30% of all visits completed by telemedicine, compared to 10-15% for other solid tumor groups. The striking difference between telehealth visit utilization in neuro-oncology and general medical oncology even after expiration of the COVID-19 Public Health Emergency expiration and end of pandemic-related restrictions, underscores the potential value of convenient access to care for patients with central nervous system tumors. Given widespread use of telehealth in neuro-oncology, prospective evaluation to determine the safety, usability, and acceptance of video-enabled, telehealth visits is critical. Such data may lead to broader adoption of telehealth, lead to regulatory and reimbursement reform for telehealth sustainability, and improve clinical trial access and accruals.

目的:在 COVID-19 大流行期间,监管和报销政策的变化为患者提供了更多通过远程医疗获得神经肿瘤学治疗的机会。在此,我们讨论了在神经肿瘤学中使用远程医疗的益处和局限性。我们回顾了 COVID-19 大流行后远程医疗服务的使用情况:在 COVID-19 大流行期间,神经肿瘤科的远程医疗利用率为 52%,而其他实体瘤组的利用率为 27-29%。大流行后,在 2021 年 1 月至 2024 年 4 月期间,神经肿瘤科的远程医疗利用率一直居高不下,所有就诊中约有 30% 是通过远程医疗完成的,而其他实体瘤组的利用率仅为 10-15%。即使在 COVID-19 公共卫生紧急状态到期和大流行相关限制结束后,神经肿瘤科和普通肿瘤内科的远程医疗就诊利用率仍存在显著差异,这凸显了中枢神经系统肿瘤患者便捷就医的潜在价值。鉴于远程医疗在神经肿瘤学中的广泛应用,对视频远程医疗就诊的安全性、可用性和接受度进行前瞻性评估至关重要。这些数据可能会促进远程医疗的广泛应用,推动远程医疗可持续发展的监管和报销改革,并改善临床试验的获取和累积。
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引用次数: 0
Exploring the Role of Target Expression in Treatment Efficacy of Antibody–Drug Conjugates (ADCs) in Solid Cancers: A Comprehensive Review 探索靶点表达在抗体药物结合物 (ADC) 治疗实体癌疗效中的作用:全面综述
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-27 DOI: 10.1007/s11912-024-01576-9
Laurent Mathiot, Capucine Baldini, Octave Letissier, Antoine Hollebecque, Rastislav Bahleda, Anas Gazzah, Cristina Smolenschi, Madona Sakkal, François-Xavier Danlos, Clémence Henon, Kristi Beshiri, Vincent Goldschmidt, Claudia Parisi, Anna Patrikidou, Jean-Marie Michot, Aurélien Marabelle, Sophie Postel-Vinay, Alice Bernard-Tessier, Yohann Loriot, Santiago Ponce, Stéphane Champiat, Kaïssa Ouali

Purpose of Review

Antibody–drug conjugates (ADCs) offer a promising path for cancer therapy, leveraging the specificity of monoclonal antibodies and the cytotoxicity of linked drugs. The success of ADCs hinges on precise targeting of cancer cells based on protein expression levels. This review explores the relationship between target protein expression and ADC efficacy in solid tumours, focusing on results of clinical trials conducted between January 2019 and May 2023.

Recent Findings

We hereby highlight approved ADCs, revealing their effectiveness even in low-expressing target populations. Assessing target expression poses challenges, owing to variations in scoring systems and biopsy types. Emerging methods, like digital image analysis, aim to standardize assessment. The complexity of ADC pharmacokinetics, tumour dynamics, and off-target effects emphasises the need for a balanced approach.

Summary

This review underscores the importance of understanding target protein dynamics and promoting standardized evaluation methods in shaping the future of ADC-based cancer therapies.

综述目的 抗体-药物共轭物(ADC)利用单克隆抗体的特异性和连接药物的细胞毒性,为癌症治疗提供了一条前景广阔的途径。ADC 的成功取决于根据蛋白质表达水平对癌细胞进行精确靶向。本综述探讨了实体瘤中靶蛋白表达与ADC疗效之间的关系,重点关注2019年1月至2023年5月期间开展的临床试验结果。近期发现我们在此重点介绍已获批准的ADCs,揭示它们即使在低表达靶细胞群中也能发挥疗效。由于评分系统和活检类型的不同,评估靶点表达是一项挑战。数字图像分析等新兴方法旨在使评估标准化。本综述强调了了解靶蛋白动态和推广标准化评估方法对塑造未来基于 ADC 的癌症疗法的重要性。
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引用次数: 0
For the Long Haul: Management of Long-Term Survivors after Melanoma Systemic Therapy. 为了长远:黑色素瘤系统治疗后长期存活者的管理。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI: 10.1007/s11912-024-01541-6
Jordyn Silverstein, Neha Goyal, Katy K Tsai

Purpose of review: This review summarizes the latest advancements in survivorship care for patients with advanced melanoma who received systemic therapy and emphasizes the areas where more research is needed.

Recent findings: Over the last decade there have been remarkable advances in the treatment of advanced and metastatic melanoma. Due to these novel treatments, including several immune checkpoint inhibitors and tyrosine kinase inhibitors, there are and will continue to be increasing numbers of long-term melanoma survivors who have been treated with systemic therapy. These patients will navigate new challenges are they are essentially among the first long term survivors after these novel therapies. Survivorship care focuses on improving the health-related quality of life of patients including the physical, emotional, social and functional effects of cancer that begin at diagnosis and continue through the end of life. Survivorship also includes screening for cancer recurrence and second cancers. As the number of melanoma survivors who received systemic therapy continues to grow, the survivorship care plan will become increasingly important for optimal care of patients even after their cancer treatments. Understanding the many domains of survivorship care for this group of patients is imperative for their care now and to identify unmet needs for future research.

综述的目的:本综述总结了接受过系统治疗的晚期黑色素瘤患者生存期护理的最新进展,并强调了需要开展更多研究的领域:过去十年间,晚期和转移性黑色素瘤的治疗取得了显著进展。由于采用了这些新型治疗方法,包括几种免疫检查点抑制剂和酪氨酸激酶抑制剂,接受过全身治疗的黑色素瘤长期存活者的人数正在不断增加,而且还将继续增加。这些患者将面临新的挑战,因为他们基本上是接受这些新型疗法后的首批长期幸存者。生存期护理的重点是改善患者与健康相关的生活质量,包括从诊断开始一直持续到生命终结的癌症对身体、情感、社交和功能的影响。生存期护理还包括癌症复发和二次癌症筛查。随着接受系统治疗的黑色素瘤幸存者人数不断增加,幸存者护理计划对于患者在接受癌症治疗后的最佳护理将变得越来越重要。了解这部分患者的生存期护理的多个方面,对于他们现在的护理以及确定未来研究中尚未满足的需求都是非常必要的。
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引用次数: 0
Beyond Immune Checkpoint Inhibitors: Emerging Targets in Melanoma Therapy. 超越免疫检查点抑制剂:黑色素瘤治疗中的新靶点。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-25 DOI: 10.1007/s11912-024-01551-4
Andrew D Knight, Jason J Luke

Purpose of review: This review provides a comprehensive update on recent advancements in melanoma treatment by highlighting promising therapeutics with an aim to increase awareness of novel interventions currently in development.

Recent findings: Over the last decade there has been considerable expansion of the previously available treatment options for patients with melanoma. In particular, novel immunotherapeutics have been developed to expand on the clinical advancements brought by BRAF targeting and immune checkpoint inhibitors. Despite the success of checkpoint inhibitors there remains an unmet need for patients that do not respond to treatment. This review delves into the latest advancements in novel checkpoint inhibitors, cytokines, oncolytic viruses, vaccines, bispecific antibodies, and adoptive cell therapy. Preclinical experiments and early-stage clinical trials studies have demonstrated promising results for these therapies, many of which have moved into pivotal, phase 3 studies.

综述的目的:本综述全面介绍了黑色素瘤治疗的最新进展,重点介绍了前景看好的治疗方法,旨在提高人们对目前正在开发的新型干预措施的认识:在过去十年中,黑色素瘤患者的现有治疗方案有了很大的扩展。特别是,新型免疫疗法的开发扩大了BRAF靶向药物和免疫检查点抑制剂带来的临床进展。尽管检查点抑制剂取得了成功,但对治疗无反应的患者的需求仍未得到满足。本综述将深入探讨新型检查点抑制剂、细胞因子、溶瘤病毒、疫苗、双特异性抗体和收养细胞疗法的最新进展。这些疗法的临床前实验和早期临床试验研究已取得了令人鼓舞的成果,其中许多疗法已进入关键的第三阶段研究。
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引用次数: 0
Axillary Management: How Much Is Too Much? 腋窝管理:多少才算多?
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-15 DOI: 10.1007/s11912-024-01539-0
Nicci Owusu-Brackett, Benjin Facer, Dionisia Quiroga, Ashley Pariser, Michael Grimm, Sasha Beyer, Sachin Jhawar, Bridget A Oppong

Purpose of review: To review the current management of the axilla in breast cancer.

Recent findings: Axillary dissection is no longer indicated in patients with clinically node-negative axilla with 1-2 positive sentinel lymph nodes following upfront surgery or in patients with clinically node-negative axilla following neoadjuvant chemotherapy. Breast cancer has evolved away from routine axillary clearance to the less invasive sentinel lymph node biopsy to now complete omission of axillary sampling in select patients. We will review the most salient evidence that has shaped these practice changes over the last three decades. Current practice controversies are especially relevant for elderly populations and those receiving neoadjuvant therapy. Ongoing clinical trials will provide data to further guide breast cancer surgical management.

综述目的回顾目前对乳腺癌患者腋窝的处理方法:腋窝清扫不再适用于前期手术后腋窝临床结节阴性但有1-2个阳性前哨淋巴结的患者,也不再适用于新辅助化疗后腋窝临床结节阴性的患者。乳腺癌已从常规的腋窝清扫发展到侵袭性较小的前哨淋巴结活检,再到现在对特定患者完全不进行腋窝取样。我们将回顾过去三十年来影响这些实践变化的最重要证据。目前的实践争议与老年人群和接受新辅助治疗的患者尤为相关。正在进行的临床试验将提供进一步指导乳腺癌手术治疗的数据。
{"title":"Axillary Management: How Much Is Too Much?","authors":"Nicci Owusu-Brackett, Benjin Facer, Dionisia Quiroga, Ashley Pariser, Michael Grimm, Sasha Beyer, Sachin Jhawar, Bridget A Oppong","doi":"10.1007/s11912-024-01539-0","DOIUrl":"10.1007/s11912-024-01539-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the current management of the axilla in breast cancer.</p><p><strong>Recent findings: </strong>Axillary dissection is no longer indicated in patients with clinically node-negative axilla with 1-2 positive sentinel lymph nodes following upfront surgery or in patients with clinically node-negative axilla following neoadjuvant chemotherapy. Breast cancer has evolved away from routine axillary clearance to the less invasive sentinel lymph node biopsy to now complete omission of axillary sampling in select patients. We will review the most salient evidence that has shaped these practice changes over the last three decades. Current practice controversies are especially relevant for elderly populations and those receiving neoadjuvant therapy. Ongoing clinical trials will provide data to further guide breast cancer surgical management.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anamorelin for the Treatment of Cancer Anorexia-Cachexia Syndrome. 阿那莫林治疗癌症厌食-痛风综合征。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-21 DOI: 10.1007/s11912-024-01549-y
Rony Dev, Koji Amano, Tateaki Naito, Egidio Del Fabbro

Purpose of review: The following review will highlight the development of anamorelin to treat cancer anorexia-cachexia syndrome (CACS) including the potential benefits, limitations, and future directions.

Recent findings: Ghrelin, a 28-amino acid peptide hormone, is secreted by the stomach mucosa and regulates appetite, promotes lipogenesis, increases body weight, improves gastric motility, reduces catabolic wasting and inflammation. Several randomized, double-blind, placebo-controlled clinical trials evaluating anamorelin, a ghrelin agonist, for the treatment of CACS have reported improvement in appetite and body composition including both lean body and fat mass; however, most studies noted no improvement in physical function as assessed by measuring non-dominant hand-grip strength. Common adverse effects of anamorelin include the development of diabetes mellitus, hyperglycemia, and less frequently, hepatic abnormalities and cardiovascular events including conduction abnormalities, hypertension, and ischemic cardiomyopathy. Anamorelin has the potential to stimulate appetite, improve gastric movement, and may have anti-inflammatory effects on patients with CACS. In patients with cancer, studies involving anamorelin combined with other multimodal treatments including nutrition counseling (branched chain amino acids, omega 3 fatty acids, and other nutrients), exercise, treatment of hormonal abnormalities including hypogonadism and hypovitaminosis D, and anti-inflammatory agents are needed. Compliance with multimodality treatment has been a barrier and future studies may need to incorporate motivational counseling to promote adherence.

综述目的:以下综述将重点介绍开发阿那莫瑞林治疗癌症厌食-痛风综合征(CACS)的情况,包括潜在的益处、局限性和未来发展方向:胃泌素是一种 28 氨基酸的肽类激素,由胃黏膜分泌,可调节食欲、促进脂肪生成、增加体重、改善胃肠蠕动、减少分解代谢消耗和炎症。几项随机、双盲、安慰剂对照临床试验评估了阿那莫瑞林(一种胃泌素激动剂)治疗 CACS 的疗效,结果显示食欲和身体成分(包括瘦体重和脂肪量)均有所改善;但大多数研究指出,通过测量非惯用手握力评估的身体功能没有改善。阿那莫瑞林常见的不良反应包括糖尿病、高血糖的发生,以及较少见的肝功能异常和心血管事件,包括传导异常、高血压和缺血性心肌病。阿那莫瑞林有可能刺激食欲、改善胃肠蠕动,并可能对 CACS 患者产生抗炎作用。对于癌症患者,需要进行阿那莫瑞林与其他多模式治疗相结合的研究,包括营养咨询(支链氨基酸、欧米伽 3 脂肪酸和其他营养物质)、运动、治疗激素异常(包括性腺功能减退和维生素 D 缺乏)和抗炎药物。多模式治疗的依从性一直是一个障碍,未来的研究可能需要结合动机咨询来促进依从性。
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引用次数: 0
Advancements in the Management of Synchronous Colorectal Liver Metastases: A Comprehensive Review of Surgical, Systemic, and Local Treatment Modalities. 同步性结直肠癌肝转移的治疗进展:手术、系统和局部治疗模式的全面回顾。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-22 DOI: 10.1007/s11912-024-01548-z
Beliz Bahar Karaoğlan, Diğdem Kuru Öz, Mine Soylu Araz, Cihangir Akyol, Güngör Utkan

Purpose of review: This review addresses the current landscape of colorectal cancer (CRC) with a focus on liver metastases, the third most common cancer globally. It explores recent findings in treatment strategies, emphasizing the dynamic interplay between surgery, systemic chemotherapy, and local therapies for synchronous colorectal liver metastases (CRLMs).

Recent findings: Highlighting the role of advanced imaging, the review underscores the significance of contrast-enhanced MRI in surgical planning for CRLMs. Surgical resection remains a primary choice for resectable cases, with considerations for oncologic scoring systems and tumor biology. Perioperative systemic chemotherapy plays a pivotal role, especially in conversion therapy for initially unresectable CRLMs. The review also explores various local therapies, including radiofrequency ablation, microwave ablation, stereotactic body radiotherapy, hepatic arterial infusional chemotherapy, selective internal radiation therapy, and transarterial chemoembolization for unresectable cases. A comprehensive approach, integrating surgery, systemic chemotherapy, and local therapies, is crucial for managing synchronous CRLMs. Surgical resection and perioperative chemotherapy are key players, guided by considerations of tumor biology and scoring systems. For unresectable cases, local therapies offer viable alternatives, emphasizing the need for tailored treatments. Multidisciplinary collaboration among medical oncologists, surgeons, and radiologists is essential. Ongoing research will refine treatment approaches, while emerging technologies hold promise for further advancements in managing colorectal liver metastases.

综述目的:本综述探讨了结直肠癌(CRC)的现状,重点关注肝转移这一全球第三大常见癌症。它探讨了治疗策略方面的最新发现,强调了手术、全身化疗和同步结直肠肝转移瘤(CRLMs)局部疗法之间的动态相互作用:最新研究结果:综述强调了先进成像技术的作用,强调了对比增强磁共振成像对同步性结直肠肝转移瘤手术规划的重要意义。手术切除仍是可切除病例的首要选择,同时要考虑肿瘤评分系统和肿瘤生物学因素。围手术期全身化疗起着关键作用,尤其是在最初无法切除的 CRLM 的转化治疗中。该综述还探讨了各种局部疗法,包括射频消融、微波消融、立体定向体部放疗、肝动脉灌注化疗、选择性内放射治疗和经动脉化疗栓塞治疗不可切除病例。手术、全身化疗和局部治疗相结合的综合方法对于治疗同步性 CRLMs 至关重要。手术切除和围手术期化疗是关键,以肿瘤生物学和评分系统为指导。对于无法切除的病例,局部治疗提供了可行的替代方案,强调了量身定制治疗的必要性。肿瘤内科医生、外科医生和放射科医生之间的多学科合作至关重要。正在进行的研究将完善治疗方法,而新兴技术则有望进一步推动结直肠肝转移的治疗。
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引用次数: 0
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