Allen-Mersh T G, Glover C, Fordy C, Mathur P, Quinn H
Department of Surgical Oncology, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, UK.
Eur J Surg Oncol. 2000 Aug;26(5):468-73. doi: 10.1053/ejso.1999.0924.
We report a prospective randomized study comparing survival, response and toxicity in colorectal liver metastasis (CLM) patients treated by either hepatic arterial floxuridine (HAI) plus continuous systemic fluorouracil/folinic acid or systemic fluorouracil/folinic acid.
Eighty-four CLM patients received either HAI plus systemic fluorouracil/folinic acid or systemic fluorouracil/ folinic acid.
Significantly more HAI plus systemic, compared with systemic only, patients developed WHO grade 3 or 4 diarrhoea (P=0.004), but significant quality of life differences were not detected. Liver metastasis partial response at 4 months after randomization was significantly greater (P=0.003) in HAI plus systemic (13/29, 45%) compared with systemic only (7/30, 23%) patients. There was no significant difference between groups in the proportion of patients who died from extrahepatic disease progression, or in survival.
Combining regional with systemic fluorinated pyrimidines did not improve survival compared with systemic fluorinated pyrimidine.
我们报告一项前瞻性随机研究，比较接受肝动脉氟尿苷（HAI）联合持续静脉氟尿嘧啶/亚叶酸或单纯静脉氟尿嘧啶/亚叶酸治疗的结直肠癌肝转移（CLM）患者的生存率、反应和毒性。
84例CLM患者接受HAI联合静脉氟尿嘧啶/亚叶酸或单纯静脉氟尿嘧啶/亚叶酸治疗。
与单纯静脉治疗相比，接受HAI联合静脉治疗的患者出现世界卫生组织3级或4级腹泻的比例显著更高（P = 0.004），但未检测到显著的生活质量差异。随机分组后4个月时，HAI联合静脉治疗组（13/29，45%）的肝转移部分缓解率显著高于单纯静脉治疗组（7/30，23%）（P = 0.003）。两组在死于肝外疾病进展的患者比例或生存率方面无显著差异。
与单纯静脉氟嘧啶治疗相比，区域性与全身性氟嘧啶联合治疗并未提高生存率。
