Iwahashi M, Tanimura H, Nakamori M, Nagai Y, Hirabayashi N, Ueda K, Matsuda K, Tsunoda T, Yamaue H
Second Department of Surgery, Wakayama Medical School, Japan.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2504-10.
BACKGROUND/AIMS: The prognosis for gastric and esophageal cancer patients with liver metastases remains very poor. In most cases, liver metastasis is unresectable because of its number, size and location and therefore, other approaches need to be considered.
In this study we examined 4 patients. We showed the therapeutic benefits of employing hepatic arterial infusion of low-dose CDDP and 5-FU combined with hyperthermia for the treatment of liver metastases of gastric and esophageal cancer.
All patients showed partial response, and bone marrow toxicities and gastrointestinal toxicities were extremely slight while liver toxicities were not observed at all. Moreover, 3 of the patients excluding patient 3 who had metastatic lesions other than liver metastases have still been alive for more than 17 months (17-28 months) maintaining a good quality of life.
Therefore, it is suggested that the merits of both low dose-FP and hepatic arterial infusion chemotherapy contribute to ideal clinical effects, and that hyperthermotherapy could enhance clinical responses without potentiating any toxicities. However, this is just a preliminary study, and therefore, a prospective randomized control study is necessary to evaluate the efficiency of this therapy.
背景/目的:伴有肝转移的胃癌和食管癌患者预后仍然很差。在大多数情况下,由于肝转移灶的数量、大小和位置,肝转移无法切除,因此需要考虑其他治疗方法。
在本研究中,我们检查了4例患者。我们展示了采用肝动脉灌注低剂量顺铂和5-氟尿嘧啶联合热疗治疗胃癌和食管癌肝转移的治疗效果。
所有患者均显示部分缓解,骨髓毒性和胃肠道毒性极其轻微,且未观察到肝毒性。此外,除患者3(其有肝转移以外的转移病灶)外,其他3例患者存活超过17个月(17 - 28个月),生活质量良好。
因此,提示低剂量FP和肝动脉灌注化疗的优点共同促成了理想的临床效果,热疗可增强临床反应而不增加任何毒性。然而,这只是一项初步研究,因此,有必要进行前瞻性随机对照研究以评估该治疗方法的疗效。