Local Treatments in the Unresectable Patient with Colorectal Cancer Metastasis: A Review from the Point of View of the Medical Oncologist

Abstract

For patients with isolated liver metastases from colorectal cancer who are not candidates for potentially curative resections, non-surgical local treatments may be useful. Non-surgical local treatments are classified according to how the treatment is administered. Local treatments are applied directly on hepatic parenchyma, such as radiofrequency, microwave hyperthermia and cryotherapy. Locoregional therapies are delivered through the hepatic artery, such as chemoinfusion, chemoembolization or selective internal radiation with Yttrium 90 radioembolization. The purpose of this review is to describe the different interventional therapies that are available for these patients in routine clinical practice, the most important clinical trials that have tried to demonstrate the effectiveness of each therapy and recommendations from principal medical oncologic societies.

Neoadjuvant Chemotherapy Followed by Radiofrequency Ablation May Be a New Treatment Modality for Colorectal Liver Metastasis: A Propensity Score Matching Comparative Study

“…Therefore, during chemotherapy, the changes in liver metastases should be observed and the treatment strategy should be adjusted promptly. Combining guidelines and our center’s clinical experience, this study provides the indications for RFA following NAC [ 15 , 46 , 47 ]. (I) Unresectable liver metastasis resulting from progression after NAC; (II) intraoperative combined hepatectomy; (III) due to the combination of NAC, the diameter of liver metastases could be widened to about 5 cm, and the number of liver metastases could be widened to about 5–7; (IV) patient preferences; (V) World Health Organization (WHO) poor performance status.…”

The Biological Effects of Compound Microwave Exposure with 2.8 GHz and 9.3 GHz on Immune System: Transcriptomic and Proteomic Analysis

“…It is well-known that microwaves can activate immune responses via both thermal and nonthermal effects. As an adjuvant approach, microwave ablation has been widely used in cancer therapy, such as non-small cell lung cancer, hepatic carcinoma, and colorectal cancer [ 24 , 25 , 26 , 27 ]. It has been reported that IL-2 and IFN-γ in plasma increase significantly in patients with non-small cell lung cancer, 1 month after microwave ablation [ 28 ].…”

Hyperforin Suppresses Oncogenic Kinases and Induces Apoptosis in Colorectal Cancer Cells

“…Poor diet, lack of physical activity, obesity, drinking alcoholic beverages, and cigarette smoking are risk factors for CRC formation (2,3). Current treatment options such as surgery, chemotherapy, radiotherapy, and target therapy are being used for CRC (4). For improving the prognosis of CRC patients, a strategy to develop effective adjuvant therapies potentiating anti-CRC efficacy of current treatment options is of utmost need (5)(6)(7).…”