动脉灌注化疗原发性肝癌脑转移瘤37例探讨  

Arterial infusion chemotherapy for 37 cases of primary liver cancer with brain metastasis

作　　者：乔新荣 张建民 郑爱花 

机构地区：[1]郑州市第九人民医院,郑州450053 [2]河南省驻马店市第一人民医院

出　　处：《临床医学》2015年第9期19-20,共2页Clinical Medicine

摘　　要：目的探讨经动脉灌注治疗原发性肝癌脑转移瘤的效果及并发症。方法 37例肝癌脑转移患者接受颅内动脉灌注化疗,每4周治疗一次,连续3次,两个月复查头部增强核磁共振并进行疗效评价。结果 37例患者均完成3次治疗,手术者动脉插管并灌注治疗成功者37例,术后头痛者13例,均属于轻度不需要处理;中度疼痛11例,给予镇痛处理。发热15例,38.4℃以下13例,未予药物治疗;38.5℃以上2例,给予药物退热。术中、术后未发生严重感染。37例患者完全缓解3例(8.11%),部分缓解21例(56.76%),无变化8例(21.62%),进展5例(13.51%),有效率为64.86%(24/37),患者术后随访24个月,中位生存期8个月,6个月生存期31例(83.78%),9个月生存期4例(10.81%),12个月生存期2例(5.41%),不满1年者18例(48.65%)。结论经动脉灌注治疗肝癌脑转移是具有延长患者生存期,提高患者生活质量,术后全身不良反应轻,微创的治疗方法。Objective To study the effect of arterial infusion on primary liver cancer brain metastasis and the complications. Methods Thirty-seven cases of cerebral metastasis from hepatoeellular carcinoma accepted intraeranial artery infusion chemothera- py, once every 4 weeks, 3 times in a row, two months later, the enhanced MRI of the head was made and the effect was evaluated. Results The 37 patients all completed 3 times treatment, 37 cases had successful artery intubation and perfusion treatment, 13 ea- ses had headache after operation, the pain was mild, not needs processing, morderate pain in 11 cases, given analgesic processing, fever in 15 cases, below 38.4 degrees in 13 cases, not need drug treatment; above 38.5 degrees in 2 cases, given drugs. There was no serious infection during and after the operation. Among the 37 patients, 3 cases（8. 11% ） had complete remission, 21 cases （56. 76% ） had part remission, 8 cases （21.62%） had no changes, 5 cases （ 13. 51% ） had progress, the effective rate was 64. 86%. During the follow-up of 24 months, the middle survival period was 8 months, 31 eases（83.78% ） had 6 months survival period, 4 cases（ 10. 81% ） had 9 months survival period, 2 cases（5.41% ） had 12 months survival period, 18 eases（48. 65% ） had less than one year survival period. Conclusion Artery infusion in treatment of liver cancer with brain metastasis can prolong pa- tient survival time and improve the quality of life, has light postoperative systemic toxicity and minimal invasion.

关 键 词：肝癌 脑转移 动脉灌注 全身不良反应 

分 类 号：R735.7[医药卫生—肿瘤]