Yoshimatsu Kazuhiko, Osawa Gakuji, Yokomizo Hajime, Yano Yuki, Nakayama Mao, Okayama Sachiyo, Matsumoto Atsuo, Fujimoto Takashi, Morita Satoru, Naritaka Yoshihiko
Hepatogastroenterology. 2015 May;62(139):612-4.
BACKGROUND/AIMS: This retrospective report evaluated the safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) for life threatening patients with unresectable hepatic metastases.
Seven life threatening patients with hepatic metastases who were treated with HAIC up to September 2011 were retrospectively analyzed. As HAIC regimen, 5-FU (1000mg/m2) was administered weekly via continuous 5-hour infusion using a continuous-infusion device. After improvement of liver dysfunction, cetuximab was administered simultaneously by the same dose of single administration. Treatment was repeated weekly until progression of hepatic lesion or discontinuity by unacceptable toxicity or patients' proposal.
In 5 patients with hepatic metastasis related complaints, 3 patients improved after the initiation of HAIC. Three out of 4 patients with PS 2 or 3 were improved by the initiation of HAIC. The median OS was 9.5 months. No severe adverse toxicities and no treatment death related to HAIC were observed. The most severe non-hematologic adverse events were ALP in 3 patients, transaminase and bilirubin in 1 patient with grade 3.
HAIC may be considered to perform when the hepatic metastases progress as life threatening status even though those are refractory to standard systemic chemotherapy.
背景/目的:本回顾性报告评估了肝动脉灌注化疗(HAIC)对患有无法切除的肝转移且危及生命的患者的安全性和有效性。
回顾性分析了截至2011年9月接受HAIC治疗的7例患有危及生命的肝转移患者。作为HAIC方案,5-氟尿嘧啶(5-FU,1000mg/m²)每周通过持续输注装置连续5小时输注给药。肝功能障碍改善后,同时给予相同剂量的单次给药西妥昔单抗。每周重复治疗,直至肝脏病变进展或因不可接受的毒性或患者提议而中断。
在5例有肝转移相关主诉的患者中,3例在开始HAIC后病情改善。4例PS 2或3级患者中有3例在开始HAIC后病情改善。中位总生存期为9.5个月。未观察到与HAIC相关的严重不良毒性和治疗死亡。最严重的非血液学不良事件是3例患者出现碱性磷酸酶升高,1例患者出现3级转氨酶和胆红素升高。
即使肝转移对标准全身化疗难治,但当进展到危及生命状态时,可考虑进行HAIC治疗。