Hamada H, Sasaki F, Hata Y, Sawada H, Tamura M, Abe T, Sato N, Une Y, Uchino J, Saito H
First Dept. of Surgery, Hokkaido University, School of Medicine.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):2783-7.
Six cases of unresectable hepatic cancer in infant were treated with intra-arterial infusion therapy. The histological types were hepatoblastoma and hepatocellular carcinoma, 3 cases respectively. The clinical stages were 1 recurrent case in I, 1 in IIIA, 2 in IIIB and 2 in IV. Seldinger method and cannulation at laparotomy were employed in 4 cases and 2 cases, respectively. In the eldest case, a catheter with dual lumen reservoir developed in our department was inserted, making it possible to infuse drugs into hepatic artery and cutting off hepatic arterial blood flow temporarily. The anticancer drug used was ADM, CDDP, 5-FU, THP-ADM, and MMC; antiAFP-anticancer drug conjugate missile therapy was employed in 4 cases. According to image diagnosis, reduction or necrosis of tumor was observed in 5 cases. In all cases, AFP scores decreased. In 5 dead cases, 4 cases died of tumor enlargement (average survival time 16.3 months); 1 case died of DIC during chemotherapy. The other case could eventually undergo complete resection and is now alive. Intra-arterial infusion therapy seemed to be useful for patients of infant unresectable hepatic cancer.
6例婴儿不可切除肝癌采用动脉内灌注疗法治疗。组织学类型分别为肝母细胞瘤和肝细胞癌，各3例。临床分期为I期复发1例，IIIA期1例，IIIB期2例，IV期2例。分别有4例和2例采用Seldinger法和剖腹探查置管。在年龄最大的病例中，插入了我们科室研制的带双腔储液器的导管，从而能够向肝动脉内注入药物并暂时阻断肝动脉血流。使用的抗癌药物有阿霉素（ADM）、顺铂（CDDP）、5-氟尿嘧啶（5-FU）、吡柔比星（THP-ADM）和丝裂霉素（MMC）；4例采用抗甲胎蛋白-抗癌药物偶联物导弹疗法。根据影像诊断，5例观察到肿瘤缩小或坏死。所有病例甲胎蛋白（AFP）值均下降。5例死亡病例中，4例死于肿瘤增大（平均生存时间16.3个月）；1例死于化疗期间的弥散性血管内凝血（DIC）。另1例最终能够接受根治性切除，目前存活。动脉内灌注疗法对婴儿不可切除肝癌患者似乎有效。
