Arai Y, Endo T, Miyake Y, Sakamoto K, Kido C
Dept. of Diagnostic Radiology, Aichi Cancer Center.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):2731-4.
Fifty-seven patients with non-resectable liver metastases (31 from colon cancer, 26 from gastric cancer) received 5-FU, ADR, MMC combined hepatic arterial infusion therapy. (FAMia: 5-FU 334 mg/m2 qw, ADR 20 mg/m2 q4w, MMC 2.7 mg/m2 q2w; in colon cancer, 5-FU 167 mg/m2/day continuously for 3 months and then 334 mg/m2 qw). Myelo-suppression, hepatic arterial occlusion, gastroduodenal toxicity and elevation of biliary enzyme were observed at 29%, 39%, 32% and 13% in colon cancer, respectively, and at 35%, 8%, 0% and 0% in gastric cancer, respectively. Response rates evaluated by CT-scan were 63% (1 CR + 18 PR/30) in colon cancer and 79% (4 CR + 15 PR/24) in gastric cancer. Overall median survival was 352 days in colon cancer and 449 days in gastric cancer. Concerning background factors, the response rate in the well-differentiated type of colon cancer was significantly higher than in the moderately differentiated type, and significantly low in poorly differentiated medullary type gastric cancer. The existence of extra-hepatic lesions was the most important factor in survival in both cancers. [colon cancer: (-) 740 days vs (+) 267 days; gastric cancer: (-) 517 days vs (+) 245 days]. In conclusion, this therapy yields favorable direct effects on liver metastases from colon and gastric cancer without major side-effects and complications, but effective therapy of extrahepatic lesions is required for longer survival. Now, to release colon cancer patients from restrictions of continuous infusion pumps, a phase I study of weekly high dose 5-FU HAI therapy is under way.
57例不可切除肝转移患者（31例来自结肠癌，26例来自胃癌）接受了氟尿嘧啶（5-FU）、阿霉素（ADR）、丝裂霉素（MMC）联合肝动脉灌注治疗。（FAMia方案：5-FU 334mg/m²每周1次，ADR 20mg/m²每4周1次，MMC 2.7mg/m²每2周1次；结肠癌患者，5-FU 167mg/m²/天持续3个月，然后334mg/m²每周1次）。结肠癌患者中骨髓抑制、肝动脉闭塞、胃十二指肠毒性和胆汁酶升高的发生率分别为29%、39%、32%和13%，胃癌患者中分别为35%、8%、0%和0%。通过CT扫描评估的缓解率在结肠癌中为63%（1例完全缓解+18例部分缓解/30例），在胃癌中为79%（4例完全缓解+15例部分缓解/24例）。结肠癌患者的总中位生存期为352天，胃癌患者为449天。关于背景因素，高分化型结肠癌的缓解率显著高于中分化型，低分化髓样型胃癌的缓解率显著较低。肝外病变的存在是两种癌症生存的最重要因素。[结肠癌：（-）740天 vs（+）267天；胃癌：（-）517天 vs（+）245天]。总之，该疗法对结肠癌和胃癌肝转移有良好的直接效果，且无严重副作用和并发症，但为了延长生存期，需要对肝外病变进行有效治疗。目前，为使结肠癌患者摆脱持续输注泵的限制，一项每周高剂量5-FU肝动脉灌注治疗的I期研究正在进行。
