Une Y, Uchino J, Yasuhara M, Misawa K, Kamiyama T, Shimamura T, Sato N, Nakajima Y, Hata Y
First Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Clin Ther. 1993 Mar-Apr;15(2):347-54.
Intra-arterial infusion chemotherapy (IAIC) by occluding hepatic arterial flow augments intrahepatic drug concentrations, resulting in response rates higher than those with conventional infusion methods. We recently developed an intra-hepatic artery catheter and device attached with an implantable double-lumen reservoir that can be used for repeated IAIC in outpatient clinics. Eight patients with unresectable hepatocellular carcinoma were treated by infusion of anticancer drugs using this method. The catheter was inserted into the hepatic artery under laparotomy. The occlusion balloon was attached to the common hepatic artery, and catheters were connected to the subcutaneous double-lumen reservoir. Approximately 0.5 ml of distilled water was injected through the one port of the double-lumen reservoir to inflate the balloon, which compressed the artery within the cylinder-like occluder. 4'-O-tetrahydropyranyladriamycin (THP-ADM) was used as the anticancer agent, and two patients received combined administration with carboplatin. Three to seven repeated infusions were possible without any severe side effects. This treatment was also easy to perform in the outpatient clinic. Six of the eight patients survived for more than 2 years, an improvement over the survival rates obtained in a previous conventional IAIC group. We conclude that IAIC with THP-ADM for unresectable hepatocellular carcinoma under occluding blood flow using our device is more convenient and more effective than other available methods.
通过阻断肝动脉血流进行动脉内灌注化疗（IAIC）可提高肝内药物浓度，从而使缓解率高于传统灌注方法。我们最近开发了一种肝内动脉导管及与之相连的可植入双腔储液器装置，可用于门诊患者的重复IAIC治疗。8例无法切除的肝细胞癌患者采用该方法进行抗癌药物灌注治疗。在剖腹手术中将导管插入肝动脉。将阻塞球囊连接到肝总动脉，导管连接到皮下双腔储液器。通过双腔储液器的一个端口注入约0.5 ml蒸馏水使球囊膨胀，球囊在圆筒状阻塞器内压迫动脉。使用4'-O-四氢吡喃阿霉素（THP-ADM）作为抗癌药物，2例患者联合使用卡铂。可进行3至7次重复灌注且无任何严重副作用。该治疗在门诊也易于实施。8例患者中有6例存活超过2年，较之前传统IAIC组的生存率有所提高。我们得出结论，使用我们的装置在血流阻断下对无法切除的肝细胞癌进行THP-ADM的IAIC治疗比其他现有方法更方便、更有效。
