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[口服亚叶酸钙(LV)+替加氟/尿嘧啶(UFT)联合化疗及肝动脉灌注(HAI)治疗结直肠癌肝转移]

[Combined chemotherapy with oral leucovorin (LV) + tegafur/uracil (UFT) and hepatic arterial infusion (HAI) therapy for liver metastasis of colorectal cancer].

作者信息

Hasegawa Suguru, Matsumoto Shigemi, Kawashima Kazuhiko, Fujii Hideaki, Hatano Etsuro, Satoh Seiji, Ikai Iwao, Shimahara Yasuyuki

机构信息

Dept. Gastroenterological Surgery, Kyoto University Graduate School of Medicine,

出版信息

Gan To Kagaku Ryoho. 2005 Jul;32(7):1045-9.

Abstract

The liver is the most frequent metastatic site from colorectal cancer, and the control of liver metastasis is an important issue in the treatment of progressive colorectal cancer. Hepatic arterial infusion (HAI) therapy can achieve a high drug concentration in the liver and relatively low level in the systemic circulation because of the first pass effect of the drug metabolism. With the high response rate, several reports have failed to show a significant survival benefit of HAI monotherapy, partially due to its inability to control extrahepatic metastasis. In this report, we used oral tegafur/uracil (UFT) and Leucovorin (LV) combined with HAI of 5-FU for four patients with liver metastasis of colorectal carcinoma. One of two patients with unresectable multiple hepatic metastases could undergo resectional surgery after 5 courses of this therapy. Two other cases in an adjuvant setting have been surviving free of tumors. In this series, adverse effects of this therapy were acceptable, including one case of grade 3 thrombocytopenia. The benefit of this combined therapy for survival in a case of liver metastasis from CRC remains to be evaluated. We are planning phase I and II clinical studies to evaluate the efficiency and feasibility of this combination therapy.

摘要

肝脏是结直肠癌最常见的转移部位,控制肝转移是进展期结直肠癌治疗中的一个重要问题。由于药物代谢的首过效应,肝动脉灌注(HAI)疗法可使肝脏内药物浓度升高,而全身循环中的药物浓度相对较低。尽管HAI疗法的有效率较高,但一些报告未能显示出HAI单一疗法能带来显著的生存获益,部分原因是其无法控制肝外转移。在本报告中,我们对4例结直肠癌肝转移患者采用口服替加氟/尿嘧啶(UFT)和亚叶酸钙(LV)联合5-FU肝动脉灌注治疗。2例无法切除的多发肝转移患者中有1例在接受5个疗程的该治疗后能够接受手术切除。另外2例辅助治疗的患者目前无瘤存活。在本系列研究中,该治疗的不良反应是可接受的,包括1例3级血小板减少症。这种联合疗法对结直肠癌肝转移患者生存的益处仍有待评估。我们正在计划开展I期和II期临床研究,以评估这种联合疗法的有效性和可行性。

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