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[经肝动脉灌注有效治疗的伴有肝转移的胃癌]

[Gastric cancer with liver metastasis effectively treated by intra-hepatic arterial infusion].

作者信息

Aoyagi Keishiro, Koufuji Kikuo, Yano Shojiro, Miyagi Motoshi, Imaizumi Takuya, Takeda Jinryo, Shirouzu Kazuo

机构信息

Dept. of Surgery, Kurume University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2004 Oct;31(11):1678-81.

Abstract

The prognosis of gastric cancer with liver metastasis is very poor. Because many gastric cancers with liver metastasis have multiple metastatic tumors in the liver, and the indication for surgical resection is rare. Moreover, the non-curative factors of many cases are not only liver metastasis but also are lymph node metastasis and peritoneal dissemination. However, some authors have reported gastric cancer with liver metastasis was treated effectively by intra-hepatic infusion of an anti-cancer drug. In this article, we report three cases of gastric cancer with liver metastasis that are treated effectively by intra-hepatic arterial infusion of an anti-cancer drug. There were no non-curative factors except liver metastasis. The first was a H3 case treated effectively by intra-hepatic arterial infusion of 5-fluorouracil (5-FU), mitomycin C (MMC) and peroral administration of 5-FU. The metastatic liver tumors had disappeared in 14 weeks. However, the patient eventually died of liver and brain metastases in 7 months after the therapy. The second was a H2 case treated effectively by intra-hepatic arterial infusion of CDDP and peroral administration of 5'-DFUR and PSK. The metastatic liver tumors had disappeared in 4 months, and the patient is still alive without recurrence in 35 months after surgery. The third was a H2 case treated effectively by intra-hepatic arterial infusion of cisplatin (CDDP) and peroral administration of TS-1 and PSK. The size of metastatic nodules had increased, and Virchow lymph node metastasis had appeared in 28 months after surgery. The patient eventually died in 32 months after surgery. These results suggested that intra-hepatic arterial infusion of CDDP with peroral administration of TS-1 or 5'-DFUR was an effective therapy for gastric cancer with liver metastasis.

摘要

胃癌伴肝转移的预后非常差。因为许多伴有肝转移的胃癌在肝脏中有多个转移瘤,手术切除的指征很少。此外,许多病例的非治愈因素不仅是肝转移,还包括淋巴结转移和腹膜播散。然而,一些作者报道通过肝内输注抗癌药物可有效治疗伴有肝转移的胃癌。在本文中,我们报告了3例通过肝内动脉输注抗癌药物有效治疗的伴有肝转移的胃癌病例。除肝转移外无其他非治愈因素。第一例是H3期病例,通过肝内动脉输注5-氟尿嘧啶(5-FU)、丝裂霉素C(MMC)以及口服5-FU有效治疗。转移性肝肿瘤在14周内消失。然而,患者最终在治疗后7个月死于肝和脑转移。第二例是H2期病例,通过肝内动脉输注顺铂(CDDP)以及口服去氧氟尿苷(5'-DFUR)和云芝多糖(PSK)有效治疗。转移性肝肿瘤在4个月内消失,患者在手术后35个月仍存活且无复发。第三例是H2期病例,通过肝内动脉输注顺铂(CDDP)以及口服替吉奥(TS-1)和云芝多糖(PSK)有效治疗。术后28个月转移结节大小增大,且出现了魏尔啸淋巴结转移。患者最终在手术后32个月死亡。这些结果表明,肝内动脉输注顺铂联合口服替吉奥或去氧氟尿苷是治疗伴有肝转移的胃癌的有效疗法。

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