| Background: Patients with colorectal cancer often develop metastases to the liver without extra-hepatic spread. Surgical resection is the mainstay of treatment for these patients;However, only 10~ 20% of patients are suitable for a surgical approach and some patients are reluctant to receive surgery. This study was to compare the therapeutic effect between percutaneous RFA combined with systemic chemotherapy and RFA alone for these patients.Methods: From May 2001 to July 2005, 26 patients with colorectal liver metastases received cooled-tip RFA by CT or BUS guidance. The primary tumors of all patients were resected. Among them, from 3 months before RFA to 3 months after RFA, 14 patients received chemotherapy (group A), 12 patients didn't receive any chemotherapy (group B). The metastases in liver were evaluated by CT and BUS.Results: The last follow-up was in Mar 2006, 13 patients died of tumor progress, 12 patients is still alive, and 1 patient is lost to follow-up. The main complications were fever, local pain and elevation of hepatic enzyme;which could be controlled well by anti-symptom and liver protection therapy. Reactive pleural effusion occurred in 1 patient which disappeared after thoracentesis. For all patients, the median survival, 1-and 2-year survival rates were 26 months, 84.44% and 57.79% respectively, The median time to local progress was 242 days. In group A, the median survival, 1- and 2-year survival rates were 36.5 months, 92.86% and 69.84% respectively;in group B, they were 18 months, 74.07% and 42.33% respectively(P=0.0512). In group A, the median time to local progress was 217 days;in group B, it was 242 days(P=0.6644).Conclusion: RFA is safe and effective for patients with colorectal liver metastases. Oxaliplatin based chemotherapy combined with RFA can further improve thetherapeutic effect... |
PDF Full Text Request