Ishikawa O, Ohigashi H, Sasaki Y, Furukawa H, Kabuto T, Kameyama M, Nakamori S, Hiratsuka M, Imaoka S
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Am J Surg. 1994 Oct;168(4):361-4. doi: 10.1016/s0002-9610(05)80167-9.
Since hepatic metastasis is a common cause of treatment failure after curative pancreatectomy for adenocarcinoma of the pancreas, we developed a new method of postoperative hepatic perfusion chemotherapy via both the hepatic artery and portal vein. The present study was conducted to determine if this method decreases the hepatic recurrence and improves the survival rate. Following extended pancreatectomy with wide lymphatic and connective tissue clearance for pancreatic cancer, one catheter was placed in the hepatic artery and one in the portal vein. Immediately after surgery, 5-fluorouracil (125 mg/d) was continuously infused via these two routes simultaneously for 28 to 35 days. There were no treatment-related complications in the 20 patients who survived surgery. The 3-year survival rate was 54%, and the cumulative rate of death from hepatic metastasis was 8%. These figures were significantly better than those of our historical control groups. We conclude that this method should be evaluated in a prospective, randomized controlled study.
由于肝转移是胰腺癌根治性胰腺切除术后治疗失败的常见原因，我们开发了一种通过肝动脉和门静脉进行术后肝灌注化疗的新方法。本研究旨在确定该方法是否能降低肝复发率并提高生存率。在对胰腺癌进行广泛的胰腺切除并清除广泛的淋巴和结缔组织后，将一根导管置于肝动脉，另一根置于门静脉。手术后立即通过这两条途径同时持续输注5-氟尿嘧啶（125mg/d），持续28至35天。在20例术后存活的患者中未出现与治疗相关的并发症。3年生存率为54%，肝转移累积死亡率为8%。这些数字明显优于我们的历史对照组。我们得出结论，该方法应在前瞻性随机对照研究中进行评估。
