Tuchmann A, Schüller J, Kroiss A, Dinstl K
1st Dept. of Surgery, Rudolfstiftung, Vienna, Austria.
HPB Surg. 1990 Mar;2(1):21-8. doi: 10.1155/1990/27090.
Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty-seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery. There was no operative mortality. Thirteen infusion systems could not be used for chemotherapy due to dislodgement, early death and lack of follow-up. FUdR was infused every two weeks. There were minor local complications like thrombosis of the system and dislodgement of the port. Toxic effects could be managed by reducing the dose. Response to chemotherapy was evaluated by survival, clinical condition, CEA, ultrasound and CT six months after onset of arterial chemotherapy. Ten/twenty-three patients (43%) responded to therapy, eight of them died on the average 19 months after initial chemotherapy. Six patients were non-responders, seven had stable disease. Five/ten patients developed extrahepatic metastases. Mean survival time was 13.1 months, mean interval until relapse 10.6 months.
对36例患者进行了肝动脉化疗,使用的是由端口和外置泵组成的全植入式装置。27例患者有无法手术切除的结直肠癌肝转移。通过剖腹手术经胃十二指肠动脉将输注系统插入肝动脉。无手术死亡病例。13个输注系统因移位、早期死亡和缺乏随访而无法用于化疗。每两周输注氟尿苷。有一些轻微的局部并发症,如系统血栓形成和端口移位。毒性作用可通过减少剂量来控制。在动脉化疗开始6个月后,通过生存情况、临床状况、癌胚抗原、超声和CT评估化疗反应。23例患者中有10例(43%)对治疗有反应,其中8例在初始化疗后平均19个月死亡。6例患者无反应,7例病情稳定。10例患者中有5例发生肝外转移。平均生存时间为13.1个月,平均复发间隔为10.6个月。