Wang Xiao dong, Yang Ren jie
Department of Interventional Therapy, Beijing Cancer Hospital, Peking University School of Oncology, Beijing Institute for Cancer Research, Beijing 100036, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2008 Apr;40(2):225-8.
Isolated hepatic perfusion (IHP) is the best regional chemotherapy modality for treatment of unresectable liver primary cancer and liver metastases. The main principle of isolated hepatic chemotherapy is to achieve higher regional drug concentrations and thus higher exposure of tumor tissue to the agents, resulting in increased response rates, while shielding the organism from the systemic toxicity because of the much lower concentrations in the systemic circulation. At present the methods of IHP include surgical methods and methods with balloon catheter technique, which promise to provide a micro invasive procedure, but are not fully mature. The key point of successful IHP is low leakage or leakage free. The more beneficial aspect of IHP is that it can simultaneously apply hyperthermy and biologic agent TNF to improve sensitivity of chemotherapy, which is not possible in other regional chemotherapy. From previous literatures this overview is to describe the principle, procedure techniques, leakage monitor methods, hyperthermy application, administration agents, therapeutic reaction, complications and perspective of IHP.
孤立肝灌注(IHP)是治疗不可切除的肝原发性癌和肝转移瘤的最佳区域化疗方式。孤立肝化疗的主要原则是实现更高的区域药物浓度,从而使肿瘤组织更多地接触药物,提高缓解率,同时由于全身循环中药物浓度低得多,使机体免受全身毒性影响。目前,IHP的方法包括手术方法和球囊导管技术方法,有望提供一种微创方法,但尚不完全成熟。成功进行IHP的关键在于低渗漏或无渗漏。IHP更有利的方面是它可以同时应用热疗和生物制剂TNF来提高化疗敏感性,这在其他区域化疗中是不可能的。本文通过以往文献综述来描述IHP的原理、操作技术、渗漏监测方法、热疗应用、给药制剂、治疗反应、并发症及前景。