Clinical treatment of pulmonary metastases after curative resection for colorectal cancer

doi:10.3877/cma.j.issn.2095-8773.2021.01.09

Abstract

Abstract:

Except hepatic metastases, pulmonary metastases is the most common metastatic site for postoperative colorectal cancer, with an incidence of about 10%-29%. Systemic chemotherapy or combined targeted therapy are the main treatment for patients with multiple metastases. But there is still some controversy about whether to perform active surgical treatment for oligometastases. Although a large number of retrospective studies have reported higher survival rate after surgical treatment, prospective randomized clinical trials are rare, and patients undergoing surgical treatment are highly selected before surgery. So the questions is the effectiveness of surgical treatment. The relevant literatures in recent years were reviewed, hoping to provide the basis for the clinical treatment of patients who developed pulmonary metastases after curative resection for colorectal cancer.

Key words: Colorectal neoplasms, Pulmonary metastases, Systemic chemotherapy, Targeted therapies, Surgical operation

Kun Gao, Yan Zheng. Clinical treatment of pulmonary metastases after curative resection for colorectal cancer[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2021, 08(01): 56-62.

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文献	年份	患者例数	肺外转移	化疗方案	CEA水平（ng/mL）	PFS(月)	反应率	生存情况
Meimarakis等^[12]	2014	43	/	FUFIRI或mIROX	M：16.0	/	/	MST：21.8~18.9个月
杜丽娟等^[10]	2013	56	无	单药、双药联合、三药联合a	/	/	/	2年OS：55.3%；3年OS：31.4%
Tampellini等^[7]	2012	155	有	奥沙利铂双药、伊立替康双药、5-FU为基础、三药联合	77.4%>5	10.3	36.1%	MST：24.2个月
Tampellini等^[7]	2012	104	无	奥沙利铂双药、伊立替康双药、5-FU为基础	45.8%>5	10.5	35.9%	MST：31.5个月
Kim等^[13]	2012	57	/	FOLFOX、FOLFIRI、卡培他滨、卡培他滨联合5-FU/LV	M：16.6	/	/	3年OS：35.5%
Li等^[14]	2010	70	无	FOLFOX、FOLFIRI、CAPEOX	/	8	35.7%	2年OS：38.8%

文献	年份	患者例数	肺外转移	化疗方案	CEA水平（ng/mL）	PFS(月)	反应率	生存情况
Meimarakis等^[12]	2014	43	/	FUFIRI或mIROX	M：16.0	/	/	MST：21.8~18.9个月
杜丽娟等^[10]	2013	56	无	单药、双药联合、三药联合a	/	/	/	2年OS：55.3%；3年OS：31.4%
Tampellini等^[7]	2012	155	有	奥沙利铂双药、伊立替康双药、5-FU为基础、三药联合	77.4%>5	10.3	36.1%	MST：24.2个月
Tampellini等^[7]	2012	104	无	奥沙利铂双药、伊立替康双药、5-FU为基础	45.8%>5	10.5	35.9%	MST：31.5个月
Kim等^[13]	2012	57	/	FOLFOX、FOLFIRI、卡培他滨、卡培他滨联合5-FU/LV	M：16.6	/	/	3年OS：35.5%
Li等^[14]	2010	70	无	FOLFOX、FOLFIRI、CAPEOX	/	8	35.7%	2年OS：38.8%

文献	年份	患者例数	肺外转移	化疗方案	DFI（月）	CEA水平（ng/mL）	生存情况
Shiomi等^[22]	2017	42	/	/	21.0%≥36月	21.0%>5	MST：66.0个月
Karim等^[23]	2017	151	/	奥沙利铂为基础、伊立替康为基础、5-FU单药	/	/	5年OS：42.0%
Park等^[24]	2017	63	无	FOLFOX、FOLFIRI、卡培他滨^a	32.8%≥60月	92.1%<7	5年OS：61.4%
Meimarakis等^[12]	2014	171	有	FUFIRI、mIROX	66.0%≥12月	M:2.3	MST：35.2个月
Turan等^[25]	2014	108	/	5-FU为基础、奥沙利铂为基础、伊立替康为基础^b	16.7%≥12月	25.0%>5	3年OS：66.0%；5年OS：53.0%
Tampellini等^[7]	2012	50	无	奥沙利铂双药、伊立替康双药、5-FU为基础、三药联合	M：23.7	37.1%>5	MST：72.4个月
Hawkes等^[26]	2012	38	/	5-FU、奥沙利铂、伊立替康、丝裂霉素	M：20.5	M:2.0	5年OS：74.0%
Kim等^[13]	2012	48	/	FOLFOX、FOLFIRI、卡培他滨、卡培他滨联合5-FU/LV	66.7%>12个月	M:9.1	3年OS：78.3%；5年OS：51.9%

文献	年份	患者例数	肺外转移	化疗方案	DFI（月）	CEA水平（ng/mL）	生存情况
Shiomi等^[22]	2017	42	/	/	21.0%≥36月	21.0%>5	MST：66.0个月
Karim等^[23]	2017	151	/	奥沙利铂为基础、伊立替康为基础、5-FU单药	/	/	5年OS：42.0%
Park等^[24]	2017	63	无	FOLFOX、FOLFIRI、卡培他滨^a	32.8%≥60月	92.1%<7	5年OS：61.4%
Meimarakis等^[12]	2014	171	有	FUFIRI、mIROX	66.0%≥12月	M:2.3	MST：35.2个月
Turan等^[25]	2014	108	/	5-FU为基础、奥沙利铂为基础、伊立替康为基础^b	16.7%≥12月	25.0%>5	3年OS：66.0%；5年OS：53.0%
Tampellini等^[7]	2012	50	无	奥沙利铂双药、伊立替康双药、5-FU为基础、三药联合	M：23.7	37.1%>5	MST：72.4个月
Hawkes等^[26]	2012	38	/	5-FU、奥沙利铂、伊立替康、丝裂霉素	M：20.5	M:2.0	5年OS：74.0%
Kim等^[13]	2012	48	/	FOLFOX、FOLFIRI、卡培他滨、卡培他滨联合5-FU/LV	66.7%>12个月	M:9.1	3年OS：78.3%；5年OS：51.9%

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