Lorenz Kerstin, Brauckhoff Michael, Behrmann Curd, Sekulla Carsten, Ukkat Jörg, Brauckhoff Katrin, Gimm Oliver, Dralle Henning
Department of General, Visceral and Vascular Surgery, Martin-Luther University of Halle-Wittenberg, Germany.
Surgery. 2005 Dec;138(6):986-93; discussion 993. doi: 10.1016/j.surg.2005.09.020.
Hepatic metastases from medullary thyroid carcinoma (MTC) may impair quality of life by hypercalcitonemia-associated diarrhea and pain. In this prospective study, the effect of selective arterial chemoembolization (SACE) was evaluated.
Eleven patients with hepatic metastases from MTC received 1 to 9 courses of SACE using epirubicine. Symptomatic, biochemical, and morphologic responses on SACE were recorded.
Symptomatic response was observed in all symptomatic patients. However, biochemical and radiologic response occurred only in 6 patients. Liver function was not affected by SACE. One patient with unexpected concurrent pheochromocytoma metastases died after the first course. Development of side effects in the course was observed in 8 patients but were only World Health Organization grade 1. Patients' satisfaction with SACE was excellent. Long-term follow-up found 7 patients alive (1-72 months). Three patients died with tumor 6, 12, and 24 months after SACE, respectively.
SACE provided good symptom palliation for the majority of patients with hepatic metastases from MTC. However, transient remission or stabilization of hepatic metastases resulted in only 60%. Further studies using a randomized protocol are required.
甲状腺髓样癌（MTC）肝转移可因降钙素血症相关的腹泻和疼痛而损害生活质量。在这项前瞻性研究中，评估了选择性动脉化疗栓塞术（SACE）的效果。
11例MTC肝转移患者接受了1至9个疗程的表柔比星SACE治疗。记录SACE的症状、生化和形态学反应。
所有有症状的患者均观察到症状缓解。然而，生化和影像学反应仅发生在6例患者中。SACE未影响肝功能。1例意外并发嗜铬细胞瘤转移的患者在第一个疗程后死亡。8例患者在疗程中出现副作用，但仅为世界卫生组织1级。患者对SACE的满意度很高。长期随访发现7例患者存活（1至72个月）。3例患者分别在SACE后6、12和24个月死于肿瘤。
SACE为大多数MTC肝转移患者提供了良好的症状缓解。然而，肝转移的短暂缓解或稳定仅为60%。需要使用随机方案进行进一步研究。
