Nakayama T, Tamaki Y, Tohno K, Miyazaki M, Taniguchi K, Imamura H, Kanoh T, Utsunomiya T, Kikkawa N
Dept. of Surgery, Osaka National Hospital.
Gan To Kagaku Ryoho. 1993 Aug;20(11):1504-6.
Five cases of colorectal cancer with unresectable liver metastases treated from April 1992 to April 1993 in Osaka National Hospital were summarized in this paper. A silicone catheter was placed in the hepatic artery through the gastroduodenal artery by operative procedure and connected to a subcutaneously implanted reservoir. 5-FU was administered ambulatorily using Baxter Infusor (multi day type) according to a regimen of 5-day continuous infusion and subsequent 2-day rest. The patients were 4 men and 1 woman, and from 51 to 65 years old (average: 62.4 y.o.). According to criteria for antitumor effectiveness by CT scan, one patient was judged CR, two were PR, and one was PD. One case could not be estimated because of catheter obstruction. The total efficacy rate was 75%. The serum CEA level was reduced in 3 patients. As for complication, obstruction of catheter, damage to reservoir and segmental necrosis of liver were observed in 3 patients. In conclusion, our ambulatory therapy for colorectal cancer patients with liver metastases was considered to have a high potential of not only effectiveness for cancer lesion but also the improvement of patients' quality of life.
本文总结了1992年4月至1993年4月在大阪国立医院治疗的5例伴有不可切除肝转移的结直肠癌患者。通过手术将硅胶导管经胃十二指肠动脉置入肝动脉，并与皮下植入的储液器相连。使用百特输液泵（多日型）按照5天持续输注随后休息2天的方案对患者进行门诊5-氟尿嘧啶给药。患者为4名男性和1名女性，年龄在51岁至65岁之间（平均62.4岁）。根据CT扫描的抗肿瘤疗效标准，1例患者判定为完全缓解（CR），2例部分缓解（PR），1例疾病进展（PD）。1例因导管阻塞无法评估。总有效率为75%。3例患者血清癌胚抗原（CEA）水平降低。至于并发症，3例患者出现导管阻塞、储液器损坏和肝段坏死。总之，我们对伴有肝转移的结直肠癌患者的门诊治疗不仅被认为对癌灶有效，而且对改善患者生活质量具有很大潜力。
