Terashima H, Mugikura S, Furuta S, Saito M, Hirayama K
Dept. of Surgery, Hiraka General Hospital.
Gan To Kagaku Ryoho. 2001 Mar;28(3):369-72.
There have been few reports on intra-arterial infusion chemotherapy for metastatic bone cancer because the bone metastasis is multiple in almost all cases. However, selective intra-arterial infusion chemotherapy is thought to be more effective than systemic chemotherapy for solitary bone metastasis. The patient was a 47-year-old man who had been diagnosed with solitary metastasis of the right knee joint from lung cancer on the basis of various imaging studies and biopsy. The metastatic bone cancer showed rapid growth with systemic inflammatory response, and the patient's general condition became progressively worse. Therefore, radiotherapy alone consisting of 3 Gy of fraction x 5 fractions/week was initiated, but the metastatic lesion was a progressive disease (PD) at the middle point of radiotherapy (24 Gy), and we had no choice but to alter the therapy. Angiography showed dense tumor staining, so intra-arterial infusion chemotherapy was contemplated. Subsequently 15 mg/body of CDDP was administered persistently 5 days a week through a catheter placed in the right femoral artery that had been introduced via the left femoral artery. After 8 courses of this therapy (total dose 600 mg), the metastatic bone cancer was remarkably reduced in size and showed nearly a complete response (CR) on CT scan. This result suggests that intra-arterial infusion chemotherapy is very effective if there is only one bone metastasis lesion.
关于转移性骨癌的动脉内灌注化疗的报道较少,因为几乎所有病例中的骨转移都是多发性的。然而,对于孤立性骨转移,选择性动脉内灌注化疗被认为比全身化疗更有效。该患者为一名47岁男性,根据各种影像学检查和活检,被诊断为肺癌右膝关节孤立性转移。转移性骨癌伴有全身炎症反应且生长迅速,患者的一般状况逐渐恶化。因此,开始单独进行放疗,每周5次,每次3 Gy,但在放疗中期(24 Gy)转移性病灶呈疾病进展(PD),我们别无选择,只能改变治疗方案。血管造影显示肿瘤染色浓密,因此考虑进行动脉内灌注化疗。随后,通过经左股动脉插入的导管,每周5天持续向置于右股动脉的导管内注入15 mg/体的顺铂。经过8个疗程的这种治疗(总剂量600 mg)后,转移性骨癌的大小显著减小,CT扫描显示几乎完全缓解(CR)。该结果表明,如果只有一个骨转移病灶,动脉内灌注化疗非常有效。