[经皮技术进行的流量控制抗增殖灌注（停流技术）结果：30个月经验]

[Results of flow-controlled antiblastic perfusions (stop-flow technique) carried out with percutaneous technique: 30-month experience].

作者信息

Roversi R, Ricci S, Rossi G, Cavallo G, Roversi M, Fiorentini G

机构信息

Servizio di Radiologia Diagnostica, Ospedale Bellaria-C.A. Pizzardi, Bologna.

出版信息

Radiol Med. 1997 Jun;93(6):732-8.

PMID:9411522

Abstract

PURPOSE

We report the morphological and clinical results in a series of patients with advanced thoracopulmonary, abdominal, pelvic and lower limb tumors treated with stop-flow perfusion (SFP).

MATERIAL AND METHODS

We performed 77 SFPs with the percutaneous angiographic technique in 55 patients (25 women and 30 men; mean age: 53 years). Eighteen thoracic perfusions with aortocaval block (ASI) were performed in 11 patients, 33 abdominal hypoxic perfusions (HAP) in 26 patients, 17 hypoxic pelvic perfusion (HPP) in 11 patients and 9 hypoxic lower limb perfusions (HILP) in 7 patients. 42/77 procedures were followed by hemofiltration.

RESULTS

No technical complications were observed. Twenty-eight patients in our series are still alive (mean follow-up: 14 months) and 23 have died (mean survival: 8 months), 20/23 of them (87%) for disease progression. Three of 77 patients (3.8%) died within 7 days of the procedure (2 AS, 1 HAP). At CT or MR follow-up, responses > 50% were observed in 56% of the procedures and clinical CR was achieved in 53/77 patients (69%). In the subgroups classified by procedure, positive responses were observed in 56, 48, 59 and 78%, respectively for ASI, HAP, HPP and HLP. Clinical CR was observed in 67, 67, 71 and 78%, respectively. The death rate for disease progression relative to the overall death rate was 100, 86, 75 and 100%. Hematologic toxicity according to WHO criteria (mean: 2) was observed in 77% of the whole of procedures (59/77). Statistical analysis showed no relationship between morphological responses and type of antiblastic drug or previous antiblastic treatments.

CONCLUSIONS

SF procedures permit the effective control of many advanced tumors which cannot be treated otherwise, with a high rate of positive morphological and of complete clinical responses. The best results were obtained in hypoxic perfusion of the lower limb. The results were not correlated with previous antiblastic treatments. However, the high rate of sequels and the low hematologic tolerance of those procedures must be emphasized.

摘要

目的

我们报告了一系列接受停流灌注（SFP）治疗的晚期胸肺、腹部、盆腔和下肢肿瘤患者的形态学和临床结果。

材料与方法

我们采用经皮血管造影技术对55例患者（25例女性和30例男性；平均年龄：53岁）进行了77次SFP。11例患者进行了18次主动脉腔静脉阻断的胸部灌注（ASI），26例患者进行了33次腹部低氧灌注（HAP），11例患者进行了17次低氧盆腔灌注（HPP），7例患者进行了9次低氧下肢灌注（HILP）。77例手术中有42例术后进行了血液滤过。

结果

未观察到技术并发症。我们系列中的28例患者仍存活（平均随访：14个月），23例患者死亡（平均生存：8个月），其中23例中有20例（87%）死于疾病进展。77例患者中有3例（3.8%）在手术后7天内死亡（2例ASI，1例HAP）。在CT或MR随访中，56%的手术观察到反应>50%，77例患者中有53例（69%）实现了临床完全缓解（CR）。在按手术分类的亚组中，ASI、HAP、HPP和HLP的阳性反应分别为56%、48%、59%和78%。临床CR分别为67%、67%、71%和78%。疾病进展导致的死亡率相对于总死亡率分别为100%、86%、75%和100%。根据WHO标准，77%的手术（59/77）观察到血液学毒性（平均：2级）。统计分析表明形态学反应与抗瘤药物类型或既往抗瘤治疗之间无相关性。