经左锁骨下动脉留置导管肝动脉化疗栓塞加灌注治疗结直肠癌肝转移疗效观察  

Evaluationg of efficacy of transarterial therapies of liver metastses in patients with colorectal cancer

作　　者：宗登伟[1] 郭晨阳[1] 黎海亮[1] 程洪涛[1] 胡鸿涛[1] 肖金成[1] 郑琳[1] 姚全军[1] 

机构地区：[1]河南省肿瘤医院放射科,河南457000

出　　处：《当代医学》2010年第5期34-36,共3页Contemporary Medicine

摘　　要：目的评价经左锁骨下动脉留置导管肝动脉化疗栓塞加灌注治疗内科化疗无效的结直肠癌肝转移患者临床价值。方法50例结直肠癌肝转移患者均采用经左锁骨下动脉留置导管肝动脉化疗栓塞加灌注,共介入治疗124周期,化疗方案为奥沙利铂+5-氟尿嘧啶,栓塞剂采用超液化碘油。所有患者每次介入治疗前均行增强CT测量肿瘤大小,检测肿瘤标记物(CEA,CA199,CA724)。采用RECIST标准评价疗效,Kaplan-Meier计算生存率。结果本组患者完全缓解(CR)2例(4%),部分缓解(PR)15例(30%),病变稳定(SD)10例(20%),病变进展(PD)23例(46%),总有效率(CR+PR)34%(17例)。1年生存率82%,2年生存率30%。从诊断肝转移始中位生存期38个月,从介入治疗始中位生存期22个月,中位无进展生存期10个月。结论经左锁骨下动脉留置导管肝动脉化疗栓塞加灌注是治疗内科化疗无效结直肠癌肝转移患者的有效方法。Objective To evaluate local tumor control and survival rate after transarterial therapies in the palliative treatment of liver metastases in patients with colorectal cancer that were not respond to systemic chemotherapy.Methods A total of 50 patients with unresectable liver metastases of colorectal cancer that did not respond to systemic chemotherapy were repeatedly treated with transarterial therapies in 28-day intervals.Total of 124 transtarterial therapies procedures were performed（mean,2.5 sessions per patient）.The local chemotherapy protocol consisted of L-OHP and 5-Fu.Embolization was performed with lipiodol.Tumor response was evaluated with enhanced CT.The change in tumor size was calculated and the response was evaluated according to the Response Evaluation Criteria in Solid Tumors.Survival rates form first diagnosis and from first chemoembolization session were calculated according to the Kaplan-Meier method.Follow-up imaging was performed until patient death.Results Evaluation of local tumor control results in completed response（2 patients,4%）,partial response（15patients,30%）,stable disease（10 patients,20%）,and progressive disease（23 patients,46%）,and the 1-year survival rate was 82%,the 2-year survival rate was 30%.Median survival from date of diagnosis of liver metastases was 38 months and from the start of chemoemoblization treatment was 22 months,and median progression-free survival was 10 month.Conclusion Transarterial therapies are minimally invasive therapy options for palliative treatment of liver metastases in patients with colorectal cancer.

关 键 词：肝转移瘤 肝动脉 留置导管 化疗栓塞 动脉灌注 疗效 

分 类 号：R735.3[医药卫生—肿瘤]