探讨射频消融术（RFA）联合小剂量卡培他滨治疗老年大肠癌术后肝转移的疗效及安全性。

选择2010年1月至2015年7月收治的46例老年确诊为大肠癌术后肝转移患者，其中25例接受射频消融术联合卡培他滨治疗（联合治疗组），21例仅接受单药卡培他滨化疗（单纯化疗组），每日给药剂量为1 500 mg/m²，分2次口服，连用2周，3周为一周期。分别按照实体瘤的疗效评价标准（RECIST1.1）和三期增强CT评价化疗和RFA近期疗效，随访患者的远期生存情况并记录RFA并发症及化疗不良反应。

联合治疗组获得完全缓解（CR）13例，部分缓解（PR）5例，稳定（SD）4例，进展（PD）3例，有效率（RR）和疾病控制率（DCR）分别为72.0%和88.0%；单纯化疗组获得CR 0例，PR 6例，SD 7例，PD 8例，RR和DCR分别为28.5%和61.9%。联合治疗组的RR和DCR均高于单纯化疗组，差异有统计学意义(χ²=8.627、4.272，P=0.003、0.038）；肝内1个病灶的RFA疗效优于2~5个，直径≤3 cm病灶的RFA疗效优于>3~6 cm（P<0.05）。联合治疗组的1、2、3年生存率依次为72.0%（18/25）、52.0%（13/25）和21.4%（7/25），均高于单纯化疗组的47.6%（10/21）、19.0%（4/21）和4.7%（1/21），差异有统计学意义（P<0.05）。RFA主要并发症为发热和局部疼痛，两组化疗不良反应相似，以骨髓抑制和消化道反应为主，差异无统计学意义。

RFA联合小剂量卡培他滨治疗老年大肠癌术后肝转移疗效确切，可有效控制肿瘤，延长患者生存期。

To explore the clinical effect and safety of radiofrequency ablation (RFA) in combination with small doses of capecitabine for colorectal cancer patients with liver metastases.

Among forty-six patients with colorectal liver metastasis from January 2010 to July 2015, 25 cases received RFA in combination with capecitabine regimen (combined therapy group) and the other 21 cases only received capecitabine regimen (chemotherapy alone group) with daily dose of 1 500 mg/m², bid, for 2 weeks, with 3 weeks for a cycle. The curative effect of chemotherapy and RFA were analyzed according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 or three-phase enhanced CT, respectively. The long-term survival was followed up, and the complications of RFA and the chemotherapy-induced adverse reactions were recorded.

In the combined therapy group, there were 13 cases of complete response (CR), 5 partial response (PR), 4 stable disease (SD) and 3 cases of progressive disease (PD), with the response rate (RR) and disease control rate (DCR) of 72.0% and 88.0%. In the chemotherapy alone group, there were 0 case of CR, 6 PR, 7 SD and 8 PD, with RR and DCR of 28.5% and 61.9%. There was higher DCR and RR in the combined treatment group compared with the chemotherapy alone group with a significant difference (χ²=8.627、4.272, P=0.003、0.038) . The curative effect of patients with one lesion was better than those with 2-5; and less than 3 cm in diameter was better than that of 3 to 6 cm; the survival rates of 1-, 2-, 3-year were 72.0% (18/25), 52.0% (13/25) and 21.4% (7/25) in the combined treatment group, higher than 47.6% (10/21), 19.0% (4/21) and 4.7% (1/21) of the chemotherapy alone group, respectively (P<0.05). The main complications of RFA were fever and local pain. There were similar adverse reactions in both groups, mainly including bone marrow suppression and gastrointestinal reaction, and the difference had no statistical significance.

RFA in combination with small dose of capecitabine chemotherapy treatment of colorectal liver metastasis can effectively control the tumor and prolong patients' survival.