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中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2025, Vol. 14 ›› Issue (05) : 427 -435. doi: 10.3877/cma.j.issn.2095-3224.2025.05.007

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结直肠癌脑转移的临床特征与治疗策略进展
赵南1, 张明凯1, Bhargava Divija1, 赵世光1,2,†(), 张大明1,†()   
  1. 1150001　黑龙江，哈尔滨医科大学附属第一医院神经外科
    2518000　深圳，深圳大学总医院神经外科
  • 收稿日期:2025-06-03 出版日期:2025-10-25
  • 通信作者: 赵世光, 张大明
  • 基金资助:
    哈尔滨医科大学附属第一医院临床医学教育改革工程项目重点项目(No.YDYYJX202203); 国家自然科学基金(No.82272885); 深圳市科技计划资助(No.JCYJ20210324100001004); 深圳市科技计划资助(No.JCYJ20230808105205011); 广东省普通高校重点领域专项项目(No.2021ZDZX2020)

Clinical features and strategic advances in the treatment of brain metastases from colorectal cancer

Nan Zhao1, Mingkai Zhang1, Bhargava Divija1, Shiguang Zhao1,2,†(), Daming Zhang1,†()   

  1. 1Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
    2Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen 518000, China
  • Received:2025-06-03 Published:2025-10-25
  • Corresponding author: Shiguang Zhao, Daming Zhang
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引用本文：

赵南, 张明凯, Bhargava Divija, 赵世光, 张大明. 结直肠癌脑转移的临床特征与治疗策略进展[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 427-435.

Nan Zhao, Mingkai Zhang, Bhargava Divija, Shiguang Zhao, Daming Zhang. Clinical features and strategic advances in the treatment of brain metastases from colorectal cancer[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(05): 427-435.

结直肠癌是中国第二大常见的恶性肿瘤，其复发和转移是导致患者不良预后的主要原因。结直肠癌脑转移在结直肠癌晚期转移中较为罕见，但严重影响患者生存期。尽管其发病率较低，但预后显著差于其他结直肠转移癌。近年来，随着影像学技术发展和诊疗水平的提高，结直肠癌脑转移的检出率呈现逐年上升的趋势。因此，本文探讨近年来结直肠癌脑转移的流行病学特点、临床表现、诊断方法、治疗新策略及预后因素，强调现代医疗需实施多学科协作下的个体化精准治疗，应综合运用手术、放疗、化疗、靶向治疗和免疫治疗等多种手段。并进一步指出未来研究需聚焦于分子机制探索及新型治疗方法的开发，以改善患者的生活质量和总体生存率。

关键词: 结直肠癌, 脑转移, 临床流行病, 免疫治疗, 预后

Colorectal cancer is the second most common malignancy in China, with recurrence and metastasis being the leading causes of poor prognosis. Brain metastases from colorectal cancer are relatively rare among distant metastatic sites but exert a profound adverse impact on patient survival. Despite their low incidence, the prognosis of colorectal cancer patients with brain metastases is significantly worse than that of patients with other metastatic patterns. In recent years, with the advancement of imaging technologies and improvements in diagnostic and therapeutic approaches, the detection rate of colorectal cancer brain metastases has shown a gradual increase. This review aims to summarize the latest findings on the epidemiological features, clinical manifestations, diagnostic methods, novel treatment strategies, and prognostic factors of colorectal cancer brain metastases. It highlights the importance of implementing individualized and precision-based treatment plans through multidisciplinary collaboration, incorporating surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Furthermore, future research should focus on elucidating the underlying molecular mechanisms and developing novel therapeutic approaches to improve both the quality of life and overall survival of affected patients.

Key words: Colorectal cancer, Brain metastasis, Clinical epidemiology, Immunotherapy, Prognosis
图1 标准化的MDT决策路径
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[10] 胡铭语, 李敬东, 肖雨竹, 黄杰. 初始不可切除肝癌患者转化治疗序贯手术的临床疗效分析[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(05): 754-760.
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[12] 关旭, 杨明. 中国微创手术的光辉历程与经自然腔道取标本手术的革新之路[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 385-388.
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[15] 侯雨函, 姜福金, 王苏贵. 膀胱癌免疫治疗的研究进展[J/OL]. 中华临床医师杂志(电子版), 2025, 19(06): 471-475.
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