摘要
目的 探讨 5 氟脲嘧啶 (5 Fu)和甲酰四氢叶酸钙 (CF)经肝动脉持续性灌注治疗肝转移瘤的临床疗效。方法 对 6 8例无外科手术指征的肝转移瘤患者 (其原发病灶均已做根除术 ) ,采取经皮经股动脉或左锁骨下动脉肝动脉内植入药盒 ,术后经药盒每个月连续 5d持续灌注 5 Fu5 0 0mg/m2 、CF10 0mg/m2 及地塞米松 10mg(d1～ 5 ) ,并选择顺铂、丝裂霉素、表阿霉素、环磷酰胺联合化疗。结果 总有效率 (完全缓解 +部分缓解 )为 47.1%。肿瘤负荷 <2 5 %者的有效率为 6 0 .6 % ,明显高于肿瘤负荷 >2 5 %者 (34.3% ,P <0 .0 5 )。在随访的 5 4例中 ,中位生存期为 15 .2个月 ,1,2年生存率分别为 6 1.1%和 35 .2 %。来源于胃肠癌肝转移者疗效较好 ,其中位生存期为 17.6个月 ,1,2年生存率分别为 6 8.4%和 39.5 %。全组无严重毒副作用或并发症 ,胃肠道及肝胆毒性较低。结论 经药盒肝动脉持续性灌注 5 Fu、CF及地塞米松是治疗肝转移瘤的较好方法 ,可明显提高疗效 ,改善患者的生存质量。
Objective To evaluate the efficacy of continuous hepatic arterial infusion of 5 fluorouracil (5 Fu)/calcium folinate (CF) through an implanted percutaneous arterial infusion system for nonresectable liver metastasis.Methods Sixty eight patients with nonresectable liver metastasis received continuous hepatic arterial infusion of 5 Fu 500 mg/m 2·d, CF 100 mg/m 2·d and dexamethasone 10 mg/d1 5 via a drug delivery system (DDS) implanted percutaneously with the catheter introduced via the femoral artery or left subclavian artery for 5 days, once every month in combination with cisplatin and/or mitomycin C, epirubicin and cytoxan as a multi drug protocol.Results The overall response rate (CR+PR) was 47.1% (32/68), with 2 patients giving CR and 30 PR. The response seemed to correlate with the intrahepatic tumor burden as 60.6% response rate was observed in intrahepatic tumor burden of less than 25% versus 34.3% response rate in those with more than 25% ( P < 0.05). The median survival period was 15.2 months. The 1 , 2 year survival rates were 61.1% and 35.2% respectively in 54 patients who were followed. The therapeutic result was better in patients with liver metastasis originating from the gastrointestinal tract carcinoma than those from non gastrointestinal tract carcinoma ( P < 0.05). In patients with liver metastasis originating from the gastrointestinal tract carcinoma, the median survival was 17.6 months, with 1 , 2 year survival rates of 68.4% and 39.5%. There was no severe toxic side effects or complications. The toxic reaction in liver, biliary and gastrointestinal tract was mild.Conclusion Continuous hepatic arterial infusion of 5 Fu/CF and dexamethasone via a subcutaneous drug delivery system is able to prolong the survival and improve the quality of life in patients with nonresectable liver metastasis. [
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2001年第6期493-496,共4页
Chinese Journal of Oncology
关键词
肝肿瘤
药物疗法
肝转移瘤
肝动脉灌注系统
介入性治疗
Liver neoplasms/drug therapy
Liver neoplasms/secondary
Hepatic arterial/infusion system
Interventional therapy
