Wadamori K, Oka M, Shimizu R, Tangoku A, Hazama S, Yagyu T, Suzuki T, Hatano S, Kurokawa F, Okita K
Dept. of Surgery II, Yamaguchi University School of Medicine.
Gan To Kagaku Ryoho. 1995 Sep;22(11):1669-72.
We report a case of multiple liver metastasis from ileac carcinoid treated with continuous intraarterial infusion of somatostatin analog. A 65-year-old man who complained of chest pain was admitted to Yamaguchi University Hospital School of Medicine for further examination of cardiac angina. Liver tumors, which were detected during ECHO cardiogram examination, were diagnosed as metastasis from carcinoid by percutaneous transhepatic liver biopsy. Primary tumor was found at the ileum by colonofiberscopy. We performed ileo-cecal resection and catheterization from the gastroduodenal artery for intraarterial chemotherapy under laparotomy. After the operation, the patient was treated with continuous intraarterial infusion of somatostatin analog (100 micrograms/day, 5 days/week for 16 weeks). The tumor in segment 6 (S6) disappeared, but the tumor in S2 enlarged after the therapy. Hepatic angiography confirming the drug distribution demonstrated the occlusion of the left hepatic artery. This drug was thus distributed to the tumor in S6 but not in S2. These results suggest that somatostatin analog may have a direct anti-tumor effect. Furthermore, no side effect was observed. Thus, intraarterial infusion of somatostatin analog may be a useful therapy for liver metastasis from carcinoid.
我们报告一例回肠类癌多发肝转移患者，接受了生长抑素类似物持续动脉内输注治疗。一名65岁男性因胸痛入院，山口大学医学院附属医院对其进行心脏心绞痛的进一步检查。在超声心动图检查中发现肝脏肿瘤，经皮经肝肝活检诊断为类癌转移。通过结肠镜检查在回肠发现原发肿瘤。我们进行了回盲部切除术，并在剖腹手术中经胃十二指肠动脉插管进行动脉内化疗。术后，患者接受生长抑素类似物持续动脉内输注治疗（100微克/天，每周5天，共16周）。6段（S6）的肿瘤消失，但治疗后S2段的肿瘤增大。肝血管造影证实药物分布显示左肝动脉闭塞。因此，该药物分布到了S6段的肿瘤，但未分布到S2段的肿瘤。这些结果表明生长抑素类似物可能具有直接抗肿瘤作用。此外，未观察到副作用。因此，动脉内输注生长抑素类似物可能是治疗类癌肝转移的一种有效方法。
