目的 观察雷替曲塞联合微波消融(PMCT)治疗结直肠癌肝转移的疗效.方法 对无法手术切除、使用FOLFOX和FOLFIRI方案化疗病情进展、不愿意接受靶向治疗的结直肠癌肝转移患者18例行雷替曲塞联合PMCT化疗.结果 18例患者共42个病灶,经治疗后,病灶完全坏死36个,部分坏死6个.对6个未完全坏死病灶,再次行PMCT术,术后均完全坏死.随访过程中,3例患者出现新发病灶,包括肝外转移1例,肝内转移2例；中位生存时间为26个月,1年生存率为83.3％,2年生存率为66.7％.结论 PMCT联合雷替曲塞治疗结直肠癌肝转移安全有效,值得进一步研究.%Objective To observe the therapeutic effects of raltitrexed combined with percutaneous microwave coagulation therapy (PMCT) on colorectal cancer with hepatic metastasis. Methods Raltitrexed combined with PMCT was used in the treatment of 18 patients with colorectal cancer and hepatic metastasis who could not receive excision, did not agree to receive the targeted therapy and whose tumors appeared progressive under the treatment of FOLFOX or FOLFIRI. Results After the treatment, complete tumor necrosis was observed in 36 focuses of totally 42 focuses in the 18 patients, and partial necrosis was observed in another 6 focuses. PMCT was performed once again on those 6 focuses with partial necrosis which completely necrosed after the operation. During the follow - up, new focuses were found in 3 cases that included one case of extrahepatic metastasis and two ones of intrahepatic metastasis. The middle survival time (MST) was 26 months. The one - year and two - year survival rates were 83.3% and 66.7% , respectively. Conclusion The treatment of colorectal cancer with hepatic metastasis by rallitrexed combined with percutaneous microwave coagulation is safe and effective. Further exploration and research are worthwhile.
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