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[结直肠癌肝转移肝切除术后预防性肝动脉灌注化疗的评估]

[Evaluation of prophylactic hepatic arterial infusion chemotherapy after hepatectomy for metastases from colorectal cancer].

作者信息

Tono T, Kikkawa N, Tamaki Y, Yagyu T, Mishima H, Morita T, Takemasa I, Fukuda K, Shin E, Kobayashi K

机构信息

Dept. of Surgery, Osaka National Hospital.

出版信息

Gan To Kagaku Ryoho. 1995 Sep;22(11):1500-3.

PMID:7574743
Abstract

The significance of continuous hepatic arterial infusion (HAI) chemotherapy of 5-FU to prevent recurrence in the remnant liver following curative hepatectomy for colorectal metastases was analyzed in the prospective randomized study. Patients of HAI chemotherapy group received 6 weeks of 5-FU 500 mg/day. The one- and two-year overall survival rates of nine patients with HAI therapy were 87.5% and 87.5%, respectively, while the rates of ten cases without the regional chemotherapy were 100% and 66.7%, respectively, indicating no obvious difference. On the other hand, the disease-free survival rates of HAI Group were higher than those of control group. The disease-free survival rates of the former were 75.0% at one-year and 75.0% at two-year, and the rates of the latter were 47.6% and 47.6%, respectively. No serious complications such as severe liver dysfunction, sclerotic cholangitis or hepatic necrosis were observed. Although the follow-up period was not enough long to accurately evaluate the efficacy, local prophylactic chemotherapy by continuous infusion of 5-FU could be a promising method as an adjuvant chemotherapy after hepatic resection for colorectal metastases.

摘要

在一项前瞻性随机研究中,分析了5-氟尿嘧啶持续肝动脉灌注(HAI)化疗对预防结直肠癌肝转移根治性肝切除术后残肝复发的意义。HAI化疗组患者接受为期6周的5-氟尿嘧啶,每日500毫克。接受HAI治疗的9例患者的1年和2年总生存率分别为87.5%和87.5%,而10例未接受区域化疗的患者的相应生存率分别为100%和66.7%,差异无统计学意义。另一方面,HAI组的无病生存率高于对照组。前者的1年和2年无病生存率分别为75.0%,而后者分别为47.6%。未观察到严重肝功能障碍、硬化性胆管炎或肝坏死等严重并发症。虽然随访期不够长,无法准确评估疗效,但5-氟尿嘧啶持续灌注的局部预防性化疗作为结直肠癌肝转移肝切除术后的辅助化疗可能是一种有前景的方法。

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