Inoue Yasuhiro, Kusunoki Masato
Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,
Surg Today. 2014 Aug;44(8):1406-14. doi: 10.1007/s00595-013-0672-8. Epub 2013 Jul 28.
With the recent advances in chemotherapy for colorectal cancer, the prognosis for patients with metastatic colorectal cancer has been significantly improved. The development of the implantable port system has also enabled patients to receive multiagent chemotherapy with a more satisfactory quality of life. Historically, chemotherapy using implantable port systems was begun to obtain an oncological benefit in the treatment of locoregional cancer. In the 1950s, there was an increasing interest in perfusion techniques for the application of chemotherapeutic agents, such as nitrogen mustard, in the locoregional treatment of metastatic cancer. Among them, the treatment of liver metastasis has interested oncologists for many years. On the other hand, implantable devices were developed during the intervening decades that have enabled patients with colorectal cancer with liver metastases to be treated effectively using hepatic arterial infusion; which became more common in the 1980s. The treatment of metastatic colorectal cancer increasingly requires a multimodal approach and multiple treatment options based not on convenience, but in terms of personalization and efficacy. Therefore, it is important to optimize the pharmacokinetics of chemotherapeutic agents. Implantable port systems for colorectal cancer patients have been essential for oncological practice, and the importance of these systems will remain unchanged in the near future.
随着近期结直肠癌化疗技术的进步,转移性结直肠癌患者的预后得到了显著改善。可植入端口系统的发展也使患者能够接受多药化疗,生活质量更令人满意。从历史上看,使用可植入端口系统进行化疗最初是为了在局部癌症治疗中获得肿瘤学益处。在20世纪50年代,人们对灌注技术越来越感兴趣,这些技术用于在转移性癌症的局部治疗中应用化疗药物,如氮芥。其中,肝转移的治疗多年来一直引起肿瘤学家的关注。另一方面,在随后的几十年中开发出了可植入装置,使患有肝转移的结直肠癌患者能够通过肝动脉灌注得到有效治疗;这种治疗方法在20世纪80年代变得更加普遍。转移性结直肠癌的治疗越来越需要一种多模式方法和多种治疗选择,这些选择不是基于便利性,而是基于个性化和疗效。因此,优化化疗药物的药代动力学很重要。用于结直肠癌患者的可植入端口系统对肿瘤学实践至关重要,并且在不久的将来这些系统的重要性仍将保持不变。