Yukawa M, Furukawa J, Shingai T, Takekuni K, Azama T, Katsumoto Y, Nakaguchi K, Okajima S, Sue F, Hashimoto T
Dept. of Surgery, Suita Municipal Hospital.
Gan To Kagaku Ryoho. 2000 Oct;27(12):1977-80.
In a patient with a right hepatic artery arising from the superior mesenteric artery bearing multiple liver metastases from colon cancer, hepatic arterial chemo-embolization was performed in combination with degradable starch microspheres (DSM) administered independently to the left and replaced right hepatic artery via a percutaneal approach. As the first line chemotherapy from hepatic artery with DSM 300 mg, 5-FU 500 mg and MMC 10 mg resulted in PD. DSM 300 mg, epirubicin (EPI) 50 mg, MMC 4 mg was administered with the RHA:LHA ratio of 3:1 as a second line. Four weeks later it was evaluated as NC by angiography and by tumor-marker dropped extremely. The same regimen was repeated every four weeks, and the NC status remained for 20 weeks in total. Each time, the left and replaced right hepatic artery got perfect re-perfusion and DSM enabled an effective whole liver distribution of anti-cancer drugs and repetitive administrations of them. This regimen could be an alternative choice for patients with a replaced right hepatic artery who have liver metastasis of colon cancer.
一名右肝动脉起源于肠系膜上动脉且患有多发结肠癌肝转移的患者，通过经皮途径对左肝动脉和替代的右肝动脉独立给予可降解淀粉微球（DSM），同时进行肝动脉化疗栓塞。作为一线肝动脉化疗，给予DSM 300mg、5-氟尿嘧啶（5-FU）500mg和丝裂霉素（MMC）10mg导致疾病进展（PD）。作为二线治疗，以3:1的右肝动脉与左肝动脉比例给予DSM 300mg、表柔比星（EPI）50mg、MMC 4mg。四周后，通过血管造影评估为疾病稳定（NC），且肿瘤标志物大幅下降。每四周重复相同方案，疾病稳定状态总共维持了20周。每次，左肝动脉和替代的右肝动脉都获得了完美的再灌注，DSM使抗癌药物能够在全肝有效分布并可重复给药。对于右肝动脉替代且患有结肠癌肝转移的患者，该方案可能是一种替代选择。
