Arai Y, Kido C
Gan To Kagaku Ryoho. 1985 Oct;12(10):1922-9.
Arterial infusion chemotherapy is commonly-used modality for controlling cancers located in specific regions. Previously we described a new method of intra-hepatic arterial catheterization through the left subclavian artery using a subcutaneously-implanted silicone reservoir. In the present paper, we report our experience using a low dose-intermittent intraarterial (i.a.) infusion chemotherapy. Since February, 1982, 70 patients including 44 cases of metastatic liver cancer, 16 cases of primary hepatocellular carcinoma and 10 cases of other gastrointestinal malignancies, have been treated with this low dose-intermittent i.a. infusion chemotherapy, the drugs used being as follows. 1) MMC 4 mg, 5-FU 500 mg, AraC 40 mg/2w, 2) MMC 4 mg/w, 3) 5-FU 500 mg/w, MMC 4 mg/2w, ADM 30 mg/4w. Here, we briefly review the effectiveness of this modality for controlling regional diseases including liver metastases. The average hospital-free interval was 156 days and partial responses were observed in 43% (21/49) of cases. Side effects during the therapy were only mild bone marrow suppression and anorexia, which were tolerable in out-hospital care. We also studied the pharmacokinetics of i.a. infusion into the liver in comparison with i.v. infusion using 99mTc-RBC, and found that the ratio of i.a. to i.v. with regard to trans-arterial drug delivery to the liver was 10.0. From the viewpoints of first pass effect and increased local concentration theory, this ratio suggests that the effectiveness of a low-dose anti-tumor agent administered intraarterially is not so low. Accordingly, we believe that low dose-intermittent i.a. infusion chemotherapy is beneficial as an induction and maintenance chemotherapy for patients with regionally located cancers because it is effective, safer and prolongs the hospital-free interval.
动脉灌注化疗是控制特定部位癌症常用的治疗方式。此前我们描述了一种通过左锁骨下动脉，利用皮下植入硅胶贮器进行肝内动脉插管的新方法。在本文中，我们报告了使用低剂量间歇性动脉内（i.a.）灌注化疗的经验。自1982年2月以来，70例患者接受了这种低剂量间歇性i.a.灌注化疗，其中包括44例转移性肝癌、16例原发性肝细胞癌和10例其他胃肠道恶性肿瘤，所用药物如下：1）丝裂霉素（MMC）4毫克、氟尿嘧啶（5-FU）500毫克、阿糖胞苷（AraC）40毫克/每2周；2）MMC 4毫克/每周；3）5-FU 500毫克/每周、MMC 4毫克/每2周、阿霉素（ADM）30毫克/每4周。在此，我们简要回顾这种治疗方式对控制包括肝转移在内的局部疾病的有效性。平均无住院间隔时间为156天，43%（21/49）的病例观察到部分缓解。治疗期间的副作用仅为轻度骨髓抑制和厌食，在院外护理中可以耐受。我们还使用99m锝标记红细胞（99mTc-RBC）研究了动脉内灌注与静脉内灌注相比在肝脏中的药代动力学，发现动脉内与静脉内经动脉向肝脏输送药物的比率为10.0。从首过效应和局部浓度增加理论的角度来看，该比率表明动脉内给予低剂量抗肿瘤药物的有效性并非很低。因此，我们认为低剂量间歇性i.a.灌注化疗作为局部癌症患者的诱导和维持化疗是有益的，因为它有效、更安全且能延长无住院间隔时间。
