| Objective This retrospective study aimed to observe the clinically curative effect between chemotherapy combine with radiofrequency ablation(RFA)and chemotherapy single in treating synchronous colorectal cancer liver metastasis(CRLM)and evaluate its advantages.Methods This study was retrospectively analyzed in our hospital from Apr 2012 to Feb 2018.A total of 128 synchronous CRLM cases treated by chemotherapy or combine with RFA were divided into two groups depending on the therapeutic schedule,the group of chemotherapy combine with RFA(Treatment group)and chemotherapy single group(Control group).To reduce potential selection bias and confounding factors frequently seen in retrospective observational studies,we performed propensity score matching(PSM)between the two groups,and estimated 1:1 case propensity scores,using a logistic regression model based on patients’ CRS score,gender,number of liver metastases and location of liver metastases.The control group and the treatment group were treated according to the systematic chemotherapy regimen,and each case had at least 4 consecutive cycles of chemotherapy.In the treatment group,radiofrequency ablation was performed on the basis of chemotherapy.All patients were regularly followed up with contrast-enhanced CT or MRI.The data of patients(basic characteristics,objective response rate,disease control rate,survival time and complication)were retrospective analyzed to evaluate the effectiveness and safety of two groups.Potential prognostic factors were analyzed by Kaplan-Meier model.Results1.50 cases of patients in this study were divided into two groups,the treatment group(n = 25)and the control group(n = 25).Male to female ratio is 11.5:1 in the treat group,and the median age is 56(27-80)years old.The control group was all males,and the median age is 58(31-78)years old.All cases were follow-up of average 25.9 months(6 ~ 72).2.Objective response rate of the treatment group was significantly higher(100% vs.32% 100% VS 56%,73% VS 20%)than the control group after completing the treatment of the first month,the sixth month and the twelfth month,and all the differences were statistically significant(P < 0.01).The disease control rate of the treatment group was significantly increased(100% vs 76%)compare with the control group only at the 6th month after completion of treatment,with statistically significant differences(P < 0.05).3.At the ending of the follow-up,8 patients died and 17 patients still survival in the control group,and 6 patients died and 19 patients survival in the treatment group.The median progression free survival(PFS)of treatment group was longer than the control group(15.6 ± 15.3 VS 8.8 ± 5.2 months),with statistically significant differences(P = 0.032).Treatment group of patients with a median overall survival(OS)is longer than the control group(34.28 ± 17.4 VS 30.16 ± 16.5 months),but there was no statistically significant difference between the two groups(P = 0.592).4.The differences were no statistically significant difference(P > 0.05)in the incidence rate of complications of chemotherapy in two groups.In treatment group,different degree of pain in the piercing points or liver area was happended in all patients(25 cases),with 24% patients(6 cases)with postoperative fever and 4% patients(1 case)occured late-onset subcapsular hematoma among of them.No case was died because of radiofrequency ablation.Conclusions Both systemic chemotherapy and radiofrequency ablation were safe and effective treatment measures for the treatment of colorectal liver metastases(CRLM).Comparing with single chemotherapy,the treatment of radiofrequency ablation combining with chemotherapy had a better clinical curative efficacy and longer progression free survival time in patients of CRLM. |
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