Oka H, Ishida Y, Kojima N, Kusumoto S, Nakayoshi A
Dept. of Surgery, Showa University of Fujigoaka Hospital.
Gan To Kagaku Ryoho. 1991 Aug;18(11):1921-4.
Chemotherapy for colorectal cancer with liver metastases following surgical operation for primary tumor should be selected following surgical intervention. Continuous infusion chemotherapy using an infusional port was selected for unresectable metastasis due to colorectal cancer in our department. The catheter was placed in the hepatic artery through a gastroduodenal by operative procedure. 5-fluorouracil (5-FU) and mitomycin C (MMC) were used as chemotherapeutic agents. After MMC was given at 10 mg/body by bolus, administration of 5-FU was continuously infused at 250 mg/day for 2 weeks, followed by a 2-week interval. Drug administration was done by implanted pump hepatic arterial infusion. Seventeen of the patients with liver metastasis underwent this chemotherapy from 1986 through 1990. Results of the infusion chemotherapy were as follows. Value of serum CEA decreased until two courses were given in all cases. In 11 cases, the tumor size on CT was remarkably smaller. In these patients, however, there were many complications due to the catheter used for catheter replacement, drug leakage, drug extravasation and so on. We concluded that although this chemotherapy was very effective, the method should be improved in terms of the material, the location of catheter tip and the like.
对于原发性肿瘤手术后出现肝转移的结直肠癌患者,应在手术干预后选择化疗方案。在我们科室,对于因结直肠癌导致的不可切除转移灶,选择使用输注端口进行持续输注化疗。通过手术操作将导管经胃十二指肠置于肝动脉。化疗药物选用5-氟尿嘧啶(5-FU)和丝裂霉素C(MMC)。在静脉推注给予MMC 10mg/体后,连续2周每天持续输注5-FU 250mg,随后间隔2周。通过植入式泵进行肝动脉灌注给药。1986年至1990年期间,17例肝转移患者接受了这种化疗。输注化疗的结果如下。所有病例血清癌胚抗原(CEA)值在给予两个疗程之前均下降。11例患者CT显示肿瘤大小明显缩小。然而,在这些患者中,由于用于导管更换的导管、药物渗漏、药物外渗等原因,出现了许多并发症。我们得出结论,尽管这种化疗非常有效,但在材料、导管尖端位置等方面该方法仍需改进。