Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
J Surg Oncol. 2010 Dec 15;102(8):988-95. doi: 10.1002/jso.21753.
Hepatic metastases are common with colorectal cancer. The primary blood supply to hepatic metastases is the hepatic artery. Regional chemotherapy utilizing the hepatic artery is one treatment option for liver metastases. The advantage of hepatic arterial chemotherapy is that high concentrations of the therapeutic drug are obtained in the liver with minimal systemic toxicity. Recently, systemic chemotherapy regimens have been added to hepatic arterial infusional chemotherapy to treat hepatic metastases. Due to the high response rates in the liver, resection rates are increasing in patients originally thought to have unresectable liver disease. Hepatic arterial chemotherapy has also been used in the adjuvant setting after resection of all liver metastases in order to minimize hepatic recurrences. The role of hepatic arterial infusional therapy in treating hepatic colorectal metastases includes treating patients with both resectable and unresectable metastases in the adjuvant, neoadjuvant, or palliative settings.
肝转移是结直肠癌的常见并发症。肝转移的主要血供来自肝动脉。区域性化疗利用肝动脉是治疗肝转移的一种选择。肝动脉化疗的优点是在肝脏中获得高浓度的治疗药物，同时最小化全身毒性。最近，系统化疗方案已被添加到肝动脉灌注化疗中，以治疗肝转移。由于肝脏的高反应率，最初认为患有不可切除肝病的患者的切除率正在增加。肝动脉化疗也已在所有肝转移灶切除后的辅助治疗中使用，以最大限度地减少肝复发。肝动脉灌注治疗在治疗结直肠肝转移中的作用包括在辅助、新辅助或姑息治疗中治疗可切除和不可切除转移的患者。
