Shitara K, Ikami I, Munakata M, Muto O, Sakata Y
Department of Medical Oncology, Misawa City Hospital, Misawa, Aomori, Japan.
Clin Oncol (R Coll Radiol). 2008 Apr;20(3):241-6. doi: 10.1016/j.clon.2007.12.007. Epub 2008 Jan 25.
With no effective chemotherapy, the prognosis of unresectable intrahepatic cholangiocarcinoma is extremely poor. Hepatic arterial infusion of mitomycin C with degradable starch microspheres has been reported to be an effective treatment for unresectable liver metastasis. We retrospectively evaluated the efficacy and safety of this chemotherapy for treating unresectable intrahepatic cholangiocarcinoma.
Hepatic arterial infusion chemotherapy through an implanted port system was carried out in 20 patients with unresectable intrahepatic cholangiocarcinoma. Degradable starch microspheres mixed with mitomycin C and contrast media were injected until either embolisation of the hepatic artery or influx to the gastroduodenal system was confirmed. This treatment was repeated weekly.
Hepatic arterial infusion chemotherapy was carried out 204 times. The response rate was 50.0%. Twelve patients experienced transient epigastralgia and four experienced gastroduodenal ulcer. The time to progression was 8.3 months and the median survival time was 14.1 months.
This chemotherapy was effective and feasible for patients with unresectable intrahepatic cholangiocarcinoma. Further study with a larger number of patients is warranted.
由于缺乏有效的化疗方法，无法切除的肝内胆管癌预后极差。据报道，肝动脉灌注丝裂霉素C联合可降解淀粉微球是治疗无法切除的肝转移的有效方法。我们回顾性评估了这种化疗方法治疗无法切除的肝内胆管癌的疗效和安全性。
对20例无法切除的肝内胆管癌患者通过植入式端口系统进行肝动脉灌注化疗。将与丝裂霉素C和造影剂混合的可降解淀粉微球注入，直至确认肝动脉栓塞或流入胃十二指肠系统。每周重复此治疗。
共进行肝动脉灌注化疗204次。缓解率为50.0%。12例患者出现短暂上腹部疼痛，4例出现胃十二指肠溃疡。疾病进展时间为8.3个月，中位生存时间为14.1个月。
这种化疗方法对无法切除的肝内胆管癌患者有效且可行。有必要对更多患者进行进一步研究。
