Vogl T J, Müller P K, Mack M G, Straub R, Engelmann K, Neuhaus P
Institut für Röntgendiagnostik, Johann-Wolfgang-Goethe-Universität, Frankfurt a. M.
Chirurg. 1999 Feb;70(2):133-40. doi: 10.1007/s001040050620.
In patients with irresectable liver metastases the following spectrum of oncological concepts is in use. Percutaneous interventional methods allows for an optimized local control rate in strictly intrahepatic disease. Regional short-term time chemotherapy and transarterial chemoembolization (TACE) belong to regional methods. As local ablative methods, intratumoral drug application, endotumoral chemotherapy and alcohol instillation can be used. The most promising thermotherapeutic strategies are radiofrequency and laser-induced thermotherapy (LITT). In a prospective study 278 patients suffering from liver metastases were treated with MR-guided LITT and exact data for the local control rate and survival rate were evaluated. The overall cumulative survival rate (Kaplan-Meier) of patients with liver metastases was 40.8 months (median: 40.97 months, 95% confidence interval 36.3-45.2).
对于无法切除的肝转移患者,目前正在使用以下一系列肿瘤学概念。经皮介入方法可在严格的肝内疾病中实现优化的局部控制率。区域短期化疗和经动脉化疗栓塞(TACE)属于区域方法。作为局部消融方法,可采用瘤内药物应用、瘤内化疗和酒精注射。最有前景的热疗策略是射频和激光诱导热疗(LITT)。在一项前瞻性研究中,对278例肝转移患者进行了磁共振引导下的LITT治疗,并评估了局部控制率和生存率的准确数据。肝转移患者的总体累积生存率(Kaplan-Meier法)为40.8个月(中位数:40.97个月,95%置信区间36.3-45.2)。