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[局部热疗下动脉内大剂量注射抗癌剂后通过血液灌流快速清除抗癌剂治疗晚期肝癌]

[Intraarterial bolus infusion followed by rapid removal of anticancer agents with hemocarboperfusion under local hyperthermia in advanced hepatic cancer].

作者信息

Agishi T, Nakazawa H, Teraoka S, Fuchinoue S, Okumura T, Ota K, Akimoto S, Hamano K

出版信息

Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 2):1611-7.

PMID:3089174
Abstract

Reported herein is a new multidisciplinary treatment modality for unresectable hepatic cancer in which local hyperthermia and intraarterial infusion of bolus anticancer agent are simultaneously undertaken while anticancer agent leaking from the hepatic bed into the general circulation is rapidly removed by charcoal hemoperfusion. Local hyperthermia induced by exposure to 13.56-MHz radiofrequency waves was conducted between one and one and a half hours once or twice a week. During the hyperthermia treatment, a bolus of either 1 mg/kg Mitomycin C or 2 mg/kg Adriamycin was injected into the hepatic artery via a Vascular Access Port, the catheter portion of which had been surgically inserted into the hepatic artery and the reservoir of which had been implanted subcutaneously. In general, a regular dose of 6 mg of Mitomycin C was injected into the Vascular Access Port during the following hyperthermia procedures. In seven of nine patients (78%) treated with this method, a marked reduction in tumor size of more than 50% was observed on computed tomograms. A light to moderate degree of side effects such as leukocytopenia, thrombocytopenia, liver dysfunction or hair loss were noticed after the bolus infusion, but were not so serious as to threaten the patients' lives.

摘要

本文报道了一种针对不可切除肝癌的新的多学科治疗方法,该方法同时进行局部热疗和动脉内推注抗癌药物,同时通过活性炭血液灌注迅速清除从肝床漏入体循环的抗癌药物。通过暴露于13.56 MHz射频波诱导的局部热疗每周进行一次或两次,持续一到一个半小时。在热疗过程中,通过血管通路端口将1 mg/kg丝裂霉素C或2 mg/kg阿霉素推注到肝动脉中,该端口的导管部分已通过手术插入肝动脉,其储液器已皮下植入。一般来说,在随后的热疗过程中,向血管通路端口注射6 mg的常规剂量丝裂霉素C。用这种方法治疗的9例患者中有7例(78%)在计算机断层扫描上观察到肿瘤大小明显缩小超过50%。推注给药后出现轻度至中度的副作用,如白细胞减少、血小板减少、肝功能障碍或脱发,但并不严重到威胁患者生命。

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