Martin J K, O'Connell M J, Wieand H S, Fitzgibbons R J, Mailliard J A, Rubin J, Nagorney D M, Tschetter L K, Krook J E
Department of Surgery, Mayo Clinic, Rochester, Minn.
Arch Surg. 1990 Aug;125(8):1022-7. doi: 10.1001/archsurg.1990.01410200086013.
Seventy-four patients with liver metastasis from proved colorectal primary adenocarcinoma were entered into a prospective, randomized clinical trial to evaluate treatment with intra-arterial floxuridine compared with standard outpatient therapy with fluorouracil delivered by intravenous bolus injection. Eligible patients were randomized to hepatic arterial chemotherapy with an implanted infusion pump or systemic chemotherapy. No crossover between treatment arms was permitted, and patients were followed up to progression and death. Objective tumor response was observed in 48% of patients receiving intra-arterial floxuridine and in 21% of patients receiving intravenous fluorouracil. Time to hepatic progression was significantly longer in the group given intra-arterial therapy: 15.7 vs 6.0 months. However, time to overall progression (6.0 vs 5.0 months) and survival (12.6 vs 10.5 months) were not statistically different. Based on these data, we cannot recommend treatment with intra-arterial floxuridine as given in this study for metastatic colorectal cancer to the liver.
74例经证实为结直肠原发性腺癌肝转移的患者进入一项前瞻性随机临床试验，以评估动脉内氟尿苷治疗与氟尿嘧啶静脉推注标准门诊治疗的效果。符合条件的患者被随机分为接受植入式输液泵肝动脉化疗或全身化疗。治疗组之间不允许交叉，对患者进行随访直至病情进展和死亡。接受动脉内氟尿苷治疗的患者中有48%观察到客观肿瘤反应，接受静脉氟尿嘧啶治疗的患者中有21%观察到客观肿瘤反应。接受动脉内治疗的组肝进展时间明显更长：15.7个月对6.0个月。然而，总体进展时间（6.0个月对5.0个月）和生存时间（12.6个月对10.5个月）在统计学上没有差异。基于这些数据，我们不推荐本研究中所采用的动脉内氟尿苷治疗用于转移性结直肠癌肝转移。
