肝动脉内持续灌注治疗结直肠癌术后肝转移瘤  

Continuous hepatic arterial infusion therapy for nonresectable liver metastases from colorectal carcinoma

作　　者：朱康顺[1] 单鸿[1] 黄明声[1] 李征然[1] 姜在波[1] 关守海[1] 马壮[1] 

机构地区：[1]中山大学第三医院放射科,广州510630

出　　处：《中华放射学杂志》2002年第1期48-51,共4页Chinese Journal of Radiology

摘　　要：目的　探讨 5 氟尿嘧啶 (5 Fu) /甲酰四氢叶酸钙 (CF)经肝动脉持续性灌注治疗结直肠癌肝转移的临床疗效。方法　 6 2例无外科手术指征的结直肠癌肝转移患者 ,其原发病灶均已作根除术 ,依据肝动脉内化疗方式不同分为 2组 :A组 32例 ,采取经皮肝动脉内植入药盒 ,术后经药盒每个月连续 5d持续灌注 5 Fu/CF及地塞米松 ;B组 30例 ,采取每个月 1次肝动脉插管大剂量灌注 5 Fu/CF。结果　A、B组有效率 (完全缓解 +部分缓解 )分别为 5 0 0 %和 2 3 3%(P <0 0 5 )。A组 1年、2年生存率分别为 6 5 6 %、39 3%;B组分别为 36 7%、11 5 %(P <0 0 5 )。A组生存质量明显改善 ,肝、胆、胃十二指肠毒性均较B组低。结论　经药盒肝动脉持续性灌注 5 Fu/CF并配合地塞米松治疗结直肠癌肝转移可明显改善患者生存质量 ,提高生存率。Objective To evaluate the efficacy of continous hepatic arterial infusion chemotherapy to nonresectable liver metastases from colorectal carcinoma. Methods Sixty-two patients with nonresectable liver metastases from colorectal carcinoma had been treated with radical operation, and the patients were divided into 2 groups. (1) Group A: 32 patients received continuous hepatic arterial infusion of 5-Fluorouracil (5-Fu)/Calcium Folinate (CF) and dexamethasone via drug delivery system (DDS) implanted percutaneously for 5 days every month. (2) Group B: 30 patients were treated through one bolus arterial infusion of 5-Fu/CF each month. Results The response rate (CR+PR) of group A and B was 50.0% and 23.3%,respectively (P<0.05); the survival rate for 1 and 2 years in group A was 65.6% and 39.3%,respectively, but that in group B was 36.7% and 11.5%, respectively (P<0.05); the toxic reaction at liver, biliary, and gastrointestinal tract in group A was significantly lower than that in group B. Conclusion Continuous hepatic arterial infusion of 5-Fu/CF and dexamethasone via DDS can prolong the survival rate and improve quality of life in patients with nonresectable liver metastases from colorectal carcinoma.

关 键 词：结直肠癌 结肠癌 直肠癌 术后 肝转移瘤 肝动脉内 持续灌注 治疗 

分 类 号：R735.3[医药卫生—肿瘤] R735.7[医药卫生—临床医学]