Among patients with colorectal cancer, 30% will develop liver metastases during the course of their disease.
在结直肠癌患者中，30%的患者会在病程中会发生肝转移【1】。
Of those patients, 60% will present with metastases only to the liver.
在这些患者中，60%仅转移到肝脏【1】。
Surgical resection of colorectal liver metastases (CRLM) remains the only curative treatment option available but only a minority of patients present with initially resectable disease.
手术切除结直肠肝转移瘤(CRLM)仍然是唯一可用的治疗选择，但只有少数患者出现最初可切除的疾病【2, 3 】。
Therefore, disease control is key to optimize prognosis.
因此，疾病控制是优化预后的关键。
Despite significant progress made in systemic chemotherapy over the last decades in the treatment of CRLM, these treatments infrequently lead to cure offering a median survival of 22–24 months and a disease progression-free survival of 10 months.
尽管在过去的几十年里，全身化疗在治疗CRLM方面取得了重大进展，但这些治疗很少导致治愈，中位生存期为22-24个月，无疾病进展生存期为10个月【4】
The response rate to second-line systemic chemotherapies diminishes to 10–30%.
As a result, alternative treatment strategies such as regional delivery of chemotherapy through a hepatic arterial infusion pump (HAIP) have emerged as an effective treatment option to control disease progression in patients with uCRLM.
因此，替代治疗策略，如通过肝动脉输注泵(HAIP)进行局部化疗，已成为控制uCRLM患者疾病进展的有效治疗选择【8】。
HAIP is a catheter-based delivery of continuous chemotherapy into the hepatic artery using a subcutaneous pump.
HAIP是一种以导管为基础，使用皮下泵持续化疗进入肝动脉。
The driving principle is that CRLM derives its blood supply from the hepatic artery while normal hepatocytes are predominantly perfused through the portal vein.
其驱动原理是，CRLM的血液供应来自肝动脉，而正常的肝细胞主要通过门静脉灌注【9】。
This allows targeted delivery of chemotherapy to the liver metastases while sparing the normal liver parenchyma.
这使得对肝转移瘤进行靶向化疗，同时保留正常的肝实质。
The intra-arterial administration of chemotherapeutic agents with high first-pass hepatic extraction rate and short half-life, such as floxuridine (FUDR), limits systemic side effects and increases FUDR exposure within the liver up to 400-fold compared to systemic administration.
动脉内给药高首次肝取出率和半衰期短的化疗药物，如氟尿嘧啶(FUDR)，限制全身副作用，与全身给药相比，肝脏内FUDR暴露增加400倍【10】。
Previous work across multiple studies demonstrated promising results of HAIP combined with systemic chemotherapy compared to systemic chemotherapy alone for uCRLM.
Despite encouraging results, HAIP has been confined to a few high-volume specialized centers in North America due to concerns of safety and feasibility at other centers.
尽管结果令人鼓舞，但由于担心其他中心的安全性和可行性，HAIP一直局限于北美的一些病例多的专业中心【16】。
Several newer HAIP programs led by surgical and medical oncologists with training in HAIP insertion and treatment have emerged at several specialized institutions in North America.
在北美的几个专门机构中，出现了由外科和医学肿瘤学家接受过HAIP插入和治疗培训后领导的几个新的HAIP项目。
We performed a multicenter retrospective analysis of patients with uCRLM who received HAIP chemotherapy to examine HAIP feasibility and safety at previously inexperienced centers.
我们对接受HAIP化疗的uCRLM患者进行了多中心回顾性分析，以在以前缺乏经验的中心检查HAIP的可行性和安全性。
一、结肠癌肝转移介入治疗的历史 二、结肠癌肝转移介入治疗的现状 目前介入治疗在结肠癌肝转移所扮演的角色包括： 1. 新辅助治疗（Neoadjuvant）： 术前治疗预防结肠癌肝转移，即结肠癌切除前进行肝动脉或结肠癌供血动脉的灌注化疗，所谓新辅助治疗。它应该还包括单独介入灌注化疗，全身化疗的联合和单一治疗间的对比，以及结肠癌切除术围手术期的化疗对比，如术前化疗+术后化疗 vs 单一术前化疗等。目的是减少肝转移癌发生率或推迟肝转移癌发生的时间，或改变肝转移癌发生的形式，提高结直肠癌手术切除的生存率。 2. 辅助治疗（adjuvantive），外科术后进行介入化疗（chemotherapy post surgery） 3. 姑息性治疗，对已经出现肝转移癌的病人进行介入治疗 4. 转换治疗（conversion therapies），对不可切除的肝转移癌转换成可切除的肝转移癌。（肝转移癌手术切除的新辅助治疗） （chemotherapy given to facilitate surgery） 6. 肝转移癌手术切除的辅助治疗 7. 肝转移癌的姑息治疗 三、结肠癌肝转移介入治疗的未来 结直肠癌联合治疗（Multimodality Management）包括
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