Ito K, Hattori F, Takagi A, Kida M, Tanaka K, Matsumoto H, Kojima K, Iseki J, Toyama K, Nakajima N
Dept. of Gastroenterology, Shizuoka General Hospital.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):3041-4.
We treated 63 patients (pts) suffering from metastatic liver cancer with intra-arterial infusion chemotherapy, and analysed 44 of their for survival since the first treatment with regard to the primary foci of cancer and the method of intra-arterial therapy. Via the superficial femoral artery, we performed superselective hepatic catheterization by Seldinger's method. Three types of intraarterial therapy were used: Gelfoam embolization with mitomycin-C (MMC) in 12 pts (GS-TAE), capillary chemo-embolization with MMC-Lipiodol emulsion in 28 pts (LP-TAI) and "one-shot" slow infusion of MMC or cisplatinum in 4 pts. Fifty-percent survival was 189 days in pts with metastases from colo-rectal cancer (n = 20), 109 days from gastric cancer (n = 9), 100 days from pancreatobiliary cancer (n = 5) and 240 days from breast cancer (n = 7). More than one-year survival was obtained in 13 out of the 40 pts (32.5%). Survival of 12 pts, treated with GS-TAE regimen, was not significantly superior to that of 28 pts with LP-TAI regimen. Hence, we conclude that LP-TAI is the treatment of choice in chemo-embolization for unresectable liver metastases, because it causes less damage to the hepatic arterial beds, and facilitates repeat intraarterial therapy in these pts.
我们采用动脉内灌注化疗治疗了63例转移性肝癌患者，并对其中44例自首次治疗以来的生存情况进行了分析，分析内容涉及癌症的原发灶和动脉内治疗方法。通过股浅动脉，我们采用Seldinger法进行超选择性肝动脉插管。使用了三种类型的动脉内治疗：12例患者采用丝裂霉素-C（MMC）加明胶海绵栓塞术（GS-TAE），28例患者采用MMC-碘油乳剂进行毛细血管化疗栓塞术（LP-TAI），4例患者采用MMC或顺铂“一次性”缓慢输注。来自结直肠癌转移患者（n = 20）的50%生存率为189天，来自胃癌患者（n = 9）为109天，来自胰胆管癌患者（n = 5）为100天，来自乳腺癌患者（n = 7）为240天。40例患者中有13例（32.5%）获得了超过一年的生存期。采用GS-TAE方案治疗的12例患者的生存期并不显著优于采用LP-TAI方案治疗的28例患者。因此，我们得出结论，LP-TAI是不可切除肝转移瘤化疗栓塞的首选治疗方法，因为它对肝动脉床的损伤较小，并便于对这些患者进行重复动脉内治疗。
