Idelevich Efraim, Greif Franklin, Mavor Eli, Miller Rafael, Kashtan Hanoch, Susmalian Sergo, Ariche Arie, Brenner Baruch, Baruch Noa Ben, Dinerman Michael, Shani Adi
Institute of Oncology, Kaplan Medical Center, Rehovot, Israel.
Chemotherapy. 2009;55(2):76-82. doi: 10.1159/000183732. Epub 2008 Dec 12.
Compared with systemic therapy, hepatic arterial infusion (HAI) increases the response to fluoropyrimidines.
Thirty-one patients with non-resectable, colorectal cancer (CRC) liver metastases received irinotecan 120 mg/m(2), followed by leucovorin (LV) 20 mg/m(2) and 5-fluorouracil (5-FU) 500 mg/m(2) administered by HAI every 2 weeks, plus UFT (tegafur-uracil) 200 mg/m(2)/day with LV 30 mg/day on days 1-22, followed by a 6-day rest.
The objective response rate was 65% (all 20 patients achieving a partial response). Ten patients (32%) had stable disease. The median time to progression (TTP) and overall survival (OS) were 12 and 36 months. OS was similar in patients with low versus high expression of thymidylate synthase (TS) and/or dihydropyrimidine dehydrogenase (DPD). The regimen was well tolerated.
UFT with LV plus HAI irinotecan and 5-FU/LV was a feasible and effective treatment for non-resectable CRC liver metastases, increasing response, TTP and OS. TS and DPD levels in liver metastases did not predict outcome.
与全身治疗相比，肝动脉灌注（HAI）可提高对氟嘧啶的反应。
31例不可切除的结直肠癌（CRC）肝转移患者接受伊立替康120mg/m²，随后每2周通过HAI给予亚叶酸（LV）20mg/m²和5-氟尿嘧啶（5-FU）500mg/m²，加用优福定（替加氟-尿嘧啶）200mg/m²/天，第1至22天联合LV 30mg/天，随后休息6天。
客观缓解率为65%（所有20例患者均达到部分缓解）。10例患者（32%）疾病稳定。中位进展时间（TTP）和总生存期（OS）分别为12个月和36个月。胸苷酸合成酶（TS）和/或二氢嘧啶脱氢酶（DPD）低表达与高表达患者的OS相似。该方案耐受性良好。
优福定联合LV加HAI伊立替康及5-FU/LV是不可切除CRC肝转移的一种可行且有效的治疗方法，可提高缓解率、TTP和OS。肝转移灶中TS和DPD水平不能预测预后。
