Mavligit G M, Pollock R E, Evans H L, Wallace S
Department of Clinical Immunology and Biological Therapy, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Cancer. 1993 Jul 15;72(2):375-80. doi: 10.1002/1097-0142(19930715)72:2<375::aid-cncr2820720211>3.0.co;2-d.
Islet cell carcinoma of the pancreas is a neuroendocrine tumor often presenting with left upper quadrant mass and radiographic evidence of liver metastases. Because survival among these patients is determined largely by the pace of metastatic events in the liver, significant palliation may be achieved by regional hepatic therapy.
Five patients with islet cell carcinoma of the pancreas metastatic to the liver (four nonfunctional, one gastrin producing), were treated by hepatic arterial chemoembolization-infusion consisting of a mixture of polyvinyl alcohol sponge (150 mg) and cisplatin (150 mg) followed by 2-hour intraarterial infusion of vinblastine (10 mg/m2). Each patient received two such treatments, 1 month apart, requiring 3 to 6 days of hospital admission.
Significant tumor regression (> 50%) was observed in four of five patients, lasting from 8 to 44 months. Toxicity was limited to right upper quadrant pain, paralytic ileus requiring nasogastric suction for 24 to 72 hours, transient, mild bilirubinemia and liver enzyme elevation, hypomagnesemia and hypokalemia, and occasionally, moderate, self-limiting granulocytopenia.
This preliminary, albeit limited, experience with hepatic chemoembolization-infusion in patients with islet cell carcinoma metastatic to the liver emphasizes the high incidences of durable tumor regression that can be achieved with minimal iatrogenic intervention.
胰腺胰岛细胞癌是一种神经内分泌肿瘤，常表现为左上腹肿块及肝脏转移的影像学证据。由于这些患者的生存期在很大程度上取决于肝脏转移事件的进展速度，区域肝脏治疗可能会显著缓解症状。
5例胰腺胰岛细胞癌肝转移患者（4例无功能性，1例产生胃泌素）接受了肝动脉化疗栓塞灌注治疗，该治疗由聚乙烯醇海绵（150毫克）和顺铂（150毫克）混合组成，随后动脉内输注长春碱（10毫克/平方米）2小时。每位患者接受两次这样的治疗，间隔1个月，需要住院3至6天。
5例患者中有4例观察到显著的肿瘤消退（>50%），持续8至44个月。毒性仅限于右上腹疼痛、需要鼻胃吸引24至72小时的麻痹性肠梗阻、短暂轻度胆红素血症和肝酶升高、低镁血症和低钾血症，偶尔还有中度自限性粒细胞减少。
尽管经验有限，但对肝转移的胰岛细胞癌患者进行肝化疗栓塞灌注的这一初步经验强调，通过最小的医源性干预可实现持久肿瘤消退的高发生率。
