Goi Takanori, Murakami Makoto, Hirono Yasuo, Maeda Hiroyuki, Ishida Makoto, Kimura Toshihisa, Iida Atsushi, Katayama Kanji, Hirose Kazuo, Yamaguchi Akio
First Dept. of Surgery, Fukui Medical University.
Gan To Kagaku Ryoho. 2003 Nov;30(12):1989-91.
We report a patient with multiple hepatic metastases from colorectal cancer effectively treated by hepatic arterial infusion therapy (5-FU/LV therapy). The patient was a 55-year-old man with sigmoid colon cancer and multiple hepatic metastases, 5 cm in diameter, in both lobes of the liver. First, we locally controlled the sigmoid colon cancer by sigmoid colectomy (with D3 lymph node dissection). After resection of the primary cancer lesions and dissection of the lymph nodes, we treated the patient by systemically administering 4 courses of Leucovorin/5-FU (once weekly for 6 weeks per course) from a port-catheter system during hospital stay and in the outpatient clinic after hospital discharge. Assessment of therapeutic effects by CT showed CR in the patient. CEA levels, which were abnormal before and after surgery, decreased to normal at the end of chemotherapy. After 1 year, neither CT evidence of tumor enlargement in the liver nor re-increase in CEA levels has been noted. Although the patient experienced side effects such as pigmentation, grade 1 loss of appetite, and leukopenia, he was able to maintain his QOL in the absence of severe side effects.
我们报告了一例通过肝动脉灌注疗法(5-氟尿嘧啶/亚叶酸钙疗法)有效治疗的结直肠癌多发肝转移患者。该患者为一名55岁男性,患有乙状结肠癌并伴有肝脏两叶直径5厘米的多发肝转移。首先,我们通过乙状结肠切除术(行D3淋巴结清扫)对乙状结肠癌进行了局部控制。在切除原发癌灶和清扫淋巴结后,我们在患者住院期间通过经皮导管系统全身给予4个疗程的亚叶酸钙/5-氟尿嘧啶(每个疗程每周1次,共6周),出院后在门诊继续治疗。CT评估治疗效果显示患者达到完全缓解。术前和术后均异常的癌胚抗原(CEA)水平在化疗结束时降至正常。1年后,未发现肝脏肿瘤增大的CT证据,CEA水平也未再次升高。尽管患者出现了色素沉着、1级食欲减退和白细胞减少等副作用,但在没有严重副作用的情况下,他能够维持其生活质量。