Wells J J, Nostrant T T, Wilson J A, Gyves J W
Am J Gastroenterol. 1985 Jun;80(6):425-9.
Ninety-three patients with liver metastases underwent selective hepatic arterial infusion of chemotherapeutic agents through a surgically implanted hepatic artery catheter and pump. Fourteen patients who developed upper gastrointestinal symptoms at some time during the course of treatment were found to have gastroduodenal disease endoscopically. The severity of symptoms did not necessarily correlate with severity of endoscopic findings. There was no temporal relation between 5-fluoro-2'-deoxuridine infusion and symptoms; however, with mitomycin C, symptoms worsened in five of eight patients within 2 wk of the initial injection. Patients who received mitomycin C had more severe endoscopic findings and two of the 14 patients required partial or total gastrectomy. When biodegradable starch microspheres were coadministered with mitomycin C this was not associated with a higher incidence of gastroduodenal disease. The early experience with therapy using this system has been associated with a significant incidence of upper gastrointestinal symptoms. The presence of gastrointestinal symptoms in such patients should alert one to potentially serious disease.
93例肝转移患者通过手术植入的肝动脉导管和泵接受了选择性肝动脉化疗药物灌注。14例在治疗过程中出现上消化道症状的患者经内镜检查发现患有胃十二指肠疾病。症状的严重程度不一定与内镜检查结果的严重程度相关。5-氟-2'-脱氧尿苷灌注与症状之间没有时间关系；然而，使用丝裂霉素C时，8例患者中有5例在首次注射后2周内症状加重。接受丝裂霉素C治疗的患者内镜检查结果更严重，14例患者中有2例需要行部分或全胃切除术。当可生物降解淀粉微球与丝裂霉素C联合使用时，并未导致胃十二指肠疾病的发生率升高。使用该系统进行治疗的早期经验显示上消化道症状的发生率较高。此类患者出现胃肠道症状应提醒警惕可能存在的严重疾病。
