Kato T, Hirai T, Yasui K
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Gan To Kagaku Ryoho. 1998 Oct;25(12):1865-72.
The most common metastatic sites in colorectal cancer are the lung, liver, and the pelvis in rectal cancer. Systemic chemotherapy for these metastases is not effective. Our principle of treatment for metastatic colorectal cancer is as follows. Radical resection is the first choice of treatment if the metastases are localized. Radiation therapy and intra-arterial infusion of 5-FU is adopted if radical resection is impossible. Five-year survival rates of curative resection at our hospital for pulmonary metastases, hepatic metastases and local recurrences of rectal cancer are 35.3% (n = 44), 28.4% (n = 72) and 34.1% (n = 32), respectively. Intra-arterial hepatic continuous infusion of 5-FU and weekly high-dose infusion of 5-FU (WHF) are effective chemotherapy for inoperable hepatic metastases. For inoperable pelvic recurrence of rectal cancer, intraoperative radiation therapy, 192 Ir brachytherapy, interstitial hyperthermia and intra-arterial chemotherapy have seemed to be effective treatment methods.
结直肠癌最常见的转移部位是肺，而直肠癌是肝脏和骨盆。针对这些转移灶的全身化疗无效。我们对转移性结直肠癌的治疗原则如下。如果转移灶局限，根治性切除是首选治疗方法。如果无法进行根治性切除，则采用放疗和5-氟尿嘧啶动脉内灌注。我院对肺癌转移、肝转移和直肠癌局部复发进行根治性切除的五年生存率分别为35.3%（n = 44）、28.4%（n = 72）和34.1%（n = 32）。肝动脉内持续输注5-氟尿嘧啶和每周大剂量输注5-氟尿嘧啶（WHF）是治疗无法手术切除的肝转移灶的有效化疗方法。对于无法手术切除的直肠癌盆腔复发，术中放疗、192铱近距离放疗、间质热疗和动脉内化疗似乎是有效的治疗方法。
