探讨全身治疗的基础上联合CalliSpheres载药微球加载雷替曲塞经肝动脉栓塞治疗晚期结直肠转移肝癌患者的临床疗效及安全性。

选取2021年3月至2024年7月资阳市中心医院肿瘤中心收治的不可手术切除的结直肠肝转移癌患者50例。将患者随机分成试验组及对照组，每组25例。试验组在全身治疗（化学治疗联合靶向药物）的基础上联合CalliSpheres载药微球加载雷替曲塞行肝动脉栓塞治疗；对照组采取全身治疗，方案为化学治疗联合靶向药物。分析比较2组患者近期疗效、手术转化成功及不良反应情况。

试验组结直肠癌转移性肝癌的完全缓解（complete response，CR）率、部分缓解（partial response，PR）率、疾病稳定（stable disease，SD）率、疾病进展（progressive disease，PD）率、客观缓解率（objective response rate，ORR）和疾病控制率（disease control rate，DCR）分别为8%、60%、24%、8%、68%、92%，对照组患者的CR率、PR率、SD率、PD率、ORR和DCR分别为4%、36%、20%、40%、40%、60%，试验组ORR、DCR均高于对照组，差异均有统计学意义（P<0.05）。2组患者经转化治疗后，完成手术切除的概率分别为40%、8%，差异有统计学意义（P<0.05）。2组患者治疗期间主要不良反应是转氨酶升高、白细胞减少、中性粒细胞绝对值减少、贫血、血小板减少、胆红素升高、恶心呕吐、肌酐升高，2组患者不良反应发生率差异均无统计学意义（P>0.05）。试验组2年总生存期（overall survival，OS）高于对照组，差异有统计学意义（P<0.05）。试验组3、6、12个月无进展生存期（progression-free survival，PFS）高于对照组，差异均有统计学意义（P<0.05）。

全身治疗（化学治疗结合靶向药物）联合载药微球加载雷替曲塞行肝动脉栓塞治疗结直肠癌转移性肝癌的患者，在不增加全身不良反应的同时，临床疗效显著，且可提高手术切除的转化概率。同时可提高患者短期PFS及2年OS。值得临床推广。

To evaluate the efficacy and safety of raltitrexed-eluting microspheres for transarterial chemoembolization (TACE) combined with systemic therapy in patients with advanced colorectal cancer with liver metastases.

Fifty patients with newly diagnosed, potentially resectable colorectal cancer with liver metastases were enrolled and randomly assigned to an experimental group (n=25) or a control group (n=25). The experimental group received systemic therapy (chemotherapy plus targeted drugs) combined with TACE using raltitrexed-eluting microspheres (CalliSpheres). The control group received systemic therapy alone (chemotherapy plus targeted drugs). Short-term efficacy, surgical resection conversion rates, and adverse events were compared between groups.

In the experimental group, the complete response (CR) rate was 8%, partial response (PR) rate 60%, stable disease (SD) rate 24%, progressive disease (PD) rate 8%, objective response rate (ORR) 68%, and disease control rate (DCR) 92%. In the control group, the CR rate was 4%, PR 36%, SD 20%, PD 40%, ORR 40%, and DCR 60%. The experimental group had significantly higher ORR and DCR (P<0.05). Surgical resection conversion rates were 40% in the experimental group and 8% in the control group (P<0.05). Adverse events, including elevated transaminases, leukopenia, neutropenia, anemia, thrombocytopenia, hyperbilirubinemia, nausea, vomiting, and elevated creatinine, showed no significant difference between groups (P>0.05). The experimental group had significantly higher 2-year overall survival (OS) and progression-free survival (PFS) at 3, 6, and 12 months compared to the control group (P<0.05).

In patients with advanced colorectal cancer with liver metastases, TACE using raltitrexed-eluting microspheres combined with systemic therapy significantly improves clinical efficacy, surgical resection conversion rates, 2-year OS, and short-term PFS without increasing adverse events compared to systemic therapy alone. This approach warrants broader clinical adoption.