大肠癌肝转移介入治疗与静脉化疗的对比研究  

A comparative study on selective arterial infusion embolization and venous chemotherapy of patients with liver metastases from colorectal cancer

作　　者：卢武胜[1] 廖方义[1] 余建群[1] 谢晓东[1] 胡淑雨[1] 费泽军[1] 陈宏汉[1] 

机构地区：[1]华西医科大学附属第一医院,成都市610041

出　　处：《胃肠病学和肝病学杂志》1999年第3期222-224,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的　探讨结直肠癌肝转移的有效治疗方法。方法　肝动脉化疗灌注及栓塞治疗（ ＨＡＩＣＥ）２５ 例，第一次ＨＡＩＣＥ 后４ 周重复一次，以后每间隔３ － ６ 月行一次ＨＡＩＣＥ。静脉化疗（ＶＣ） 采用静脉给药，４ 周为１ 周期，２ 周期后间隔３－ ６ 月化疗一次。结果　ＨＡＩＣＥ 一疗程后上腹疼痛减轻或消失者占８８ ％ ，肝内肿块缩小占６８ ％ ，ＣＥＡ 降低病例占９２ ％ ；ＶＣ 一疗程后肝区疼痛减轻或消失者占１８ ％ ，肝内肿块缩小占８－３ ％ ；两组病例１ 、２ 、３ 年生存率分别为７２ ％ 、５２ ％ 、２４ ％ 和４１－７ ％ 、１６－７ ％ 、０ ％ （ Ｐ＜ ０－０１） 。结论　对于不能手术的结直肠癌肝转移，ＨＡＩＣＥ 在改善临床症状及延长生存期上较ＶＣ更有效。Aim To find out an effect method for treatment of colorectal liver metastases. Methods 25 cases with local hepatic artery infusion chemotherapy and embolization (HAICE), 12 cases with venous chemotherapy (VC). HAICE procedures were repeated 4 weeks later, two times as a course of treatment. Then HAICE was performed every 3 or 6 months. For venous chemotherapy, the route of administration was through vein, four weeks as a course of treatment, after two courses of treatment, venous chemotherapy was performed every 3 or 6 months. Result In the HAICE group,The percentage of patients,whose upper abdominal pain was relieved or disappeared, was 88%,in 68% of patients liver masses become smaller, in 92% of patients carcinoembrynic antigen (CEA) was reduced, at the end of the first course of treatment. In the VC group, 18% of patients showed that their pain of hepatic area was relieved or disapeared,only 8.3% of the patients had their liver masses become smaller, after the second treatment course. Survival rate of one year, two years and three years of HAICE and VC group was 72%, 52% 24% and 41 7%,16 7%, 0% ( P <0 01).Conclusion To treat colorectal liver metastases, HAICE is more reliable to relieve clinical symptoms and prolong the survival period compared with VC. It is a better palliative treatment of unresectable colorectal liver metastases.

关 键 词：结直肠癌 肝转移瘤 灌注化疗 栓塞治疗 

分 类 号：R735.705[医药卫生—肿瘤] R735.340.6[医药卫生—临床医学]