中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 3
Mar.  2016
Turn off MathJax
Article Contents

Clinical effect of precise sequential interventional therapy in patients with unresectable hepatic metastasis after surgery for colorectal cancer

DOI: 10.3969/j.issn.1001-5256.2016.03.025
  • Published Date: 2016-03-20
  • Objective To investigate the clinical effect of precise sequential interventional therapy in patients with unresectable hepatic metastasis after surgery for colorectal cancer. Methods The clinical data of 63 patients with unresectable hepatic metastasis after surgery for colorectal cancer,who were admitted to Air Force General Hospital,PLA from January 2005 to September 2012,were collected. According to therapeutic methods,these patients were divided into precise sequential interventional therapy group( group A,33 patients) and systemic chemotherapy group( group B,30 patients). The patients in group A underwent transcatheter arterial chemoembolization and radiofrequency ablation,and those in group B underwent systemic chemotherapy. The percentages of peripheral blood CD3+,CD4+,and CD8+T cells and CD4+/ CD8+ratio were measured before and after the initial treatment. The level of carcinoembryonic antigen( CEA) was measured and compared before the initial treatment and after the final treatment,and follow- up was conducted to observe tumor progression and survival.The t- test was applied for comparison of continuous data between groups; the chi- square test was applied for comparison of categorical data between groups; the Wilcoxon rank sum test was applied for comparison of clinical effect; the Log- Rank test was applied for comparison of survival rate. Results In group A,the percentages of CD3+,CD4+,and CD8+T cells and CD4+/ CD8+ratio changed significantly after the initial treatment( t = 4. 52,- 3. 27,2. 95,and 4. 54,all P < 0. 05); serum CEA level also changed significantly after treatment( 38. 76 ± 9. 57) μg/ml vs( 10. 53 ± 8. 62) μg/ml,t = 2. 13,P = 0. 03). The serum level of CEA after the final treatment showed a significant difference between group A and group B( 10. 53 ± 8. 62) ug / L vs( 35. 21 ± 10. 22) μg / L; t = 5. 23,P < 0. 01). Group A had a significantly higher objective response rate than group B( 66. 7% vs 43. 3%; Z =- 2. 042,P = 0. 041). Group A had a significantly longer survival time than group B,and group A had a significantly higher surrival rate than group B( 45. 5% vs 23. 3%,χ2= 3. 97,P = 0. 046).Conclusion In patients with unresectable hepatic metastasis after surgery for colorectal cancer,precise sequential interventional therapy can improve their immune function,increase clinical outcome,and prolong survival time.

     

  • loading
  • [1]LIU HZ,YANG BQ,LI YS,et al.Retrospective clinical analysis of 63 patients with liver metastasis of colorectal cancer[J/CD].Chin J Oper Proc Gen Surg:Electronic Edition,2012,6(2):41-43.(in Chinese)刘洪洲,杨丙全,李永胜,等.63例大肠癌肝转移患者的回顾性临床分析[J/CD].中华普外科手术学杂志:电子版,2012,6(2):41-43.
    [2]DAI Z,ZHENG RS,ZOU XN,et al.Analysis and prediction of colorectal cancer incidence trend in China[J].Chin J Prevent Med,2012,46(7):598-603.(in Chinese)代珍,郑荣寿,邹小农,等.中国结直肠癌发病趋势分析和预测[J].中华预防医学杂志,2012,46(7):598-603.
    [3]WENG HW,CAI XL.Investigation of quality of life and psychological conditions in patients with colorectal cancer[J/CD].J Dig Oncol:Electronic version,2014,6(1):23-27.(in Chinese)翁慧雯,蔡晓琳.结直肠患者生活质量及心理状况的调查研究[J/CD].消化肿瘤杂志:电子版,2014,6(1):23-27.
    [4]KUMAR R,PRICE TJ,BEEKE C,et al.Colorectal cancer survival:an analysis of patients with metastatic disease synchronous and metachronous with the primary tumor[J].Clin Colorectal Cancer,2014,13(2):87-93.
    [5]ABDALLA EK,JEAN-NICOLAS V,ELLIS LM,et al.Recurrence and outcomes following hepatic resection,radiofrequency ablation,and combined resection/ablation for colorectal liver metastases[J].Ann Surg,2004,239(6):818-827.
    [6]GLEISNER AL,CHOTI MA,LIA A,et al.Colorectal liver metastases:recurrence and survival following hepatic resection,radiofrequency ablation,and combined resection-radiofrequency ablation[J].Arch Surg,2008,143(12):1204-1212.
    [7]PULITANC,BODINGBAUER M,ALDRIGHETTI L,et al.Liver Resection for colorectal metastases in presence of extrahepatic disease:results from an international multi-institutional analysis[J].Ann Surg Oncol,2011,18(5):1380-1388.
    [8]MICHAEL V,LAURA K,ROHI A,et al.Radiological-pathological analysis of WHO,RECIST,EASL,mRECIST and DWI:imaging analysis from a prospective randomized trial of Y90±sorafenib.[J].Hepatology,2013,58(5):1655-1666.
    [9]DONG JH,HUANG ZQ.Precise liver resection——new concept of liver surgery in 21st century[J].Chin J Surg,2010,47(21):1601-1605.(in Chinese)董家鸿,黄志强.精准肝切除——21世纪肝脏外科新理念[J].中华外科杂志,2010,47(21):1601-1605.
    [10]CABIBBO G,LATTERI F,ANTONUCCI M,et al.Multimodal approaches to the treatment of hepatocellular carcinoma[J].Nat Clin Pract Gastroenterol Hepatol,2009,6(3):159-169.
    [11]ZHANG HY,FENG ZQ,ZHANG HY,et al.Efficacy of precise sequential therapy for primary liver cancer[J].Chin J Digest Surg,2012,11(1):73-78.(in Chinese)张洪义,冯志强,张宏义,等.原发性肝癌精准序贯治疗的疗效分析[J].中华消化外科杂志,2012,11(1):73-78.
    [12]CANNON R,ELLIS S,HAYES D,et al.Safety and early efficacy of irreversible electroporation for hepatic tumors in proximity to vital structures[J].J Surg Oncol,2013,107(5):544-549.
    [13]VOGL TJ,FARSHID P,NAGUIB NN,et al.Thermal ablation of liver metastases from colorectal cancer:radiofrequency,microwave and laser ablation therapies[J].Radiol Med,2014,7(119):451-461.
    [14]WAITZ R,SOLOMON S.Can local radiofrequency ablation of tumors generate systemic immunity against metastatic disease?[J].Radiology,2009,251(1):1-2.
    [15]HAEN SP,PEREIRA PL,SALIH HR,et al.More than just tumor destruction:immunomodulation by thermal ablation of cancer[J].Clin Dev Immunol,2011,2011:160250.
    [16]GOLDBERG SN.Science to practice:can we expand focal interventional oncologic ablation treatments into an effective systemic therapy?[J].Radiology,2013,267(2):321-323.
    [17]DROMI S,WALSH MS,TRAUGHBER B,et al.Radiofrequency ablation induces antigen-presenting cell infiltration and amplification of weak tumor-induced immunity[J].Radiology,2009,251(1):58-66.
    [18]WISSNIOWSKI TT,HAENSLER J,SCHUPPAN D,et al.Activation of tumor specific T-lymphocytes caused by radio frequency ablation of liver tumors-a patient study[J].Gastroenterology,2003,124(4):a772.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2052) PDF downloads(422) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return