Schwartz S I, Jones L S, McCune C S
Ann Surg. 1985 May;201(5):560-7. doi: 10.1097/00000658-198505000-00004.
Thirty patients in whom an implantable pump was used for hepatic arterial perfusion of chemotherapeutic agents to treat hepatic malignancy were evaluated. Three patients with primary hepatocellular carcinoma demonstrated less than 50% reduction in tumor size. One patient with metastatic gastric carcinoma and one patient with metastatic islet cell carcinoma also showed a decrease of less than 50% in the size of the tumor mass. Among the 25 patients with metastatic carcinoma from the colon or rectum, 23 had elevated carcinoembryonic antigen (CEA) levels before surgery and 75% of these revealed a reduction of at least 50%. Only three of 20 patients followed with sequential imaging studies showed a 50% decrease in the size of the tumor mass. No increase in the duration of survival could be defined when the treated patients were compared with 13 patients who had not received chemotherapy. The pump functioned well in all patients, but 77% showed signs of toxicity. This experience, coupled with a review of the literature, suggests that the procedure should be regarded as experimental and should not be applied liberally until a definite benefit can be demonstrated.
对30例使用植入式泵进行肝动脉化疗灌注治疗肝恶性肿瘤的患者进行了评估。3例原发性肝细胞癌患者的肿瘤大小缩小不到50%。1例转移性胃癌患者和1例转移性胰岛细胞癌患者的肿瘤肿块大小也减少了不到50%。在25例结肠或直肠癌转移癌患者中，23例术前癌胚抗原（CEA）水平升高，其中75%的患者肿瘤缩小至少50%。在20例接受连续影像学检查随访的患者中，只有3例患者的肿瘤肿块大小减少了50%。与13例未接受化疗的患者相比，接受治疗的患者的生存时间没有延长。该泵在所有患者中均运行良好，但77%的患者出现毒性迹象。结合文献回顾，该经验表明该手术应视为实验性手术，在明确获益之前不应随意应用。
