髂内动脉灌注化疗栓塞治疗浸润性膀胱癌疗效观察

目的 观察髂内动脉灌注化疗栓塞治疗浸润性膀胱癌的疗效.方法 28例浸润性膀胱癌进行股动脉插管超选择性髂内动脉灌注化疗(表阿霉素+奥沙利铂)栓塞,两次治疗问隔3～4周.治疗后评价疗效和毒副反应.结果 CR 8例,PR 16例,总有效率为85.7%.结论 髂内动脉灌注化疗栓塞是治疗浸润性膀胱癌的一种有效的辅助方法 ,能够降低临床分期,从而赢得手术机会,明显改善患者的生活质量,有效的降低复发率.     

动脉插管化疗联合腹腔化疗治疗晚期膀胱癌

目的探讨动脉插管化疗与腹腔化疗联合应用对于晚期膀胱癌的疗效。方法对198例由于年龄大、体质差、病情晚、无法手术切除及不能耐受全身化疗的晚期膀胱癌患者随机分为两组,其中治疗组112例,采用动脉插管化疗联合腹腔化疗;对照组86例,单独采用动脉插管化疗。结果治疗组、对照组近期有效率分别为81.25%、68.60%;治疗组和对照组1、3、5年生存率治疗组分别为73.21%、40.70%;32.14%、13.95%;20.54%、9.30%;两组1、3、5年生存率均有显著差异(P<0.05),不良反应可耐受。结论动脉插管化疗联合腹腔化疗对晚期膀胱癌的临床疗效优于单独动脉插管化疗。     

支气管动脉灌注化疗治疗中晚期肺癌88例报告

本文报道支气管动脉灌注化疗治疗中晚期肺癌８８例的近期疗效，其中鳞癌５４例，腺癌２８例，小细胞未分化癌６例，治疗总有效率达９２．９％，并对灌注化疗次数与疗效、肿瘤生长部位及缓解期等分别进行了探讨。     

髂内动脉化疗联合膀胱局部灌注治疗中晚期膀胱癌

目的：探讨术后髂内动脉介入灌注及栓塞在治疗中晚期浸润忡膀胱癌的疗效。方法：对我院1995年1月～2006年1月32例膀胱部分切除术后,髂内动脉灌注及栓塞联合膀胱灌注化疗治疗的中晚期膀胱癌患者的临床资料进行回顾性分析。结果：32例患者5年生存率为80．77％。术后2年内无因肿瘤进展死亡,仅肿瘤局部复发3例。至随访截止13期,死于术后肿瘤进展共6例。结论：髂内动脉化疗栓塞是中晚期膀胱癌膀胱部分切除术后的一种有效的辅助治疗方法,能明显提高患者的5年生存率。     

经IDDS髂内动脉化疗治疗中晚期膀胱癌的护理

目的：熟悉植入式药泵（IDD）构造,掌握中晚期膀胱癌患者髂内动脉化疗的护理方法。方法：在护理过程中加强无菌技术操作,严密观察术后并发症及化疗副反应,并及时预防和处理。结果：熟悉了药泵的构造,掌握了穿刺操作的技术,保证了植入式药泵髂内动脉灌注化疗的顺利进行。结论：掌握植入式药泵的正确操作方法及术后观察护理要点,有利于该项新技术的临床应用获得成功。     

髂内动脉内灌注化疗联合异搏定治疗晚期膀胱癌

目的：探讨髂内动脉内灌注化疗药物及异搏定对晚期膀胱癌的疗效。方法：54例（T320T434例）晚期膀胱癌患均行髂内动脉灌注异搏定10mg、THP50mg、DDP40mg，其中灌注总次数3-6次不等。结果：54例联合化疗病人总临床反应率77.8%。中位生存期35个月，除5例患出现白细胞减低副作用外，未见到其他的毒副反应。结论：髂内动脉联合灌注化疗药物和异搏定是治疗晚期膀胱癌的有效方法。     

经支气管动脉灌注化疗治疗中晚期肺癌

自１９８６年５月～１９９１年１２月对９０例中晚期肺癌患者行经选择性支气管动脉灌注化疗，获主观临床症状明显减轻；客观有效率（ＣＲ＋ＰＲ）为７７．８％，５年生存率为１５％，３年生存率为３８％的满意效果。对提高插管成功率的技术要点、化疗药物的选择、并发症的预防等问题进行了探讨     

AgNORs数量的变化在动脉化疗配合手术治疗膀胱癌中的意义

目的通过AgNORs染色分析技术检验膀胱癌动脉化疗前、后Ag,NORs均值的变化,评价膀胱癌术前行动脉化疗的意义.方法25例膀胱癌患者,经术前膀胱镜活检证实为膀胱移行细胞癌(TCC),其中Ⅱ级8例,Ⅱ～Ⅲ级4例,Ⅲ级8例,Ⅲ～Ⅳ级1例,Ⅳ级4例.经腹壁下动脉插导管至髂总动脉行ADM+CDDP联合化疗1～2个疗程后行膀胱部分切除术.将膀胱镜及手术所取之病理标本经Ag,NORs技术染色,计数其细胞核内平均AgNORs数量,进行配对t检验,并对患者进行术后随访.结果配对t值为5.230,而t(0.01)24=2.787,t＞t',所以P＜0.01,化疗前后膀胱癌组织AgNORs均值间有极显著差异.25例患者无明显并发症.经随访3年复发率为8.33%,5年复发率为12.50%,5年存活率为87.50%.结论术前经动脉化疗可降低膀胱癌的恶性程度,降低复发率,提高生存率,其效果优于单纯膀胱部分切除术+术中黏膜下注射抗癌药物,对恶性度高的膀胱癌是一种理想的治疗方法.     

肝动脉灌注化疗,栓塞化疗治疗中晚期原发性肝癌

３９例原发性肝癌共作９０次肝动脉灌注化方（ＴＡＩ）或栓塞化疗（ＴＡＥ），１８例作灌注、２１例作栓塞化疗。综合评价结果是，有效率为６６．６７％（２６／３９），半年生存率为８２．０５％。对该法的治疗价值；灌注和栓塞化疗的选择；ＡＦＰ的提示性；并发症和它们的处理或预防进行了讨论。     

区域动脉化疗在中晚期乳腺癌治疗中的应用

自１９９０年以来，采用术前静脉化疗，根治或姑息性手术，术中动脉插管皮下埋藏输液器（注射壶），术后定期给药区域动脉化疗的方法治疗Ⅲ～Ⅳ期乳腺癌患者２３例。结果显示本疗法具有安全有效，简便，副作用小而易于被患者接受的优点。     

动脉内灌注的新辅助化疗在晚期直肠癌的应用

目的探讨动脉内灌注的新辅助化疗(NACT)对晚期直肠癌的疗效。方法对36例不能切除的晚期直肠癌采用动脉置泵灌注化疗的新辅助化疗,为MFH方案:5-Fu 500 mg/m2,丝裂霉素(MMC)6 mg/m2,拓喜(HCPT)20 mg/m2,每周1次,两周1个疗程,休息4周后重复,共2—3个疗程。结果完全缓解(CR)6例,部分缓解(PR)23例,稳定(MR)7例。有效率(CR+PR)为80.5％,CR 6例全部获得手术切除,PR 23例中手术切除15例。术后病理检查发现癌细胞均有不同程度的核固缩、碎裂、胞浆凝固、变性,细胞间质水肿、纤维增生、炎细胞浸润,血管内膜增厚、血栓形成。结论动脉内灌注的新辅助化疗作为晚期直肠癌综合治疗的一部分,对改善病期,使不可能手术患者变为可能手术,提高手术切除率可以发挥重要作用,并使癌肿组织学形态发生明显改变。     

动脉插管化疗治疗中晚期膀胱肿瘤(附11例报告)

目的探讨动脉插管化疗对于中晚期膀胱肿瘤的治疗效果。方法对１１例由于年龄大、体质差、发现较晚、不能耐受麻醉和手术的中晚期膀胱肿瘤患者，采用了动脉插管化疗。结果１１例患者治疗后平均存活时间为２６．２±１３．１个月，１年生存率为８１．８％，总有效率为９０．９％，不良反应轻微。结论动脉插管化疗是目前治疗中晚期膀胱肿瘤的一种较好方法。     

局部晚期和复发直肠癌放射治疗配合动脉灌注化疗疗效分析

目的探讨动脉灌注化疗提高局部晚期和复发直肠癌放射治疗疗效。方法62例直肠癌随机分为放射治疗配合动脉灌注化疗(综合组)31例,单纯放射治疗(单放组)31例。动脉插管化疗采取经肠系膜下动脉和髂内动脉灌注,每次氟尿嘧啶600mg/m2,顺铂70mg/m2,2～3周重复,共2～3次。放射治疗采用8～18MVX射线照射,总量达DT40～50Gy时争取手术,不能手术者加量至DT60～70Gy。结果综合组有效率为83.9%,单放组有效率为54.8%(P<0.01)。综合组1、3、5年生存率分别为90.3%、68.8%、52.0%,单放组分别为80.7%、50.6%、29.8%(P<0.05),综合组和对照组中位生存时间分别为65个月和39个月。综合组副反应大,但患者均能耐受。结论放射治疗辅以动脉灌注化疗为局部晚期和复发直肠癌有效治疗方法。     

动脉插管化疗治疗中晚期膀胱肿瘤（附1例报告）

目的 探讨动脉插管化疗对于中晚期膀胱肿瘤的治疗效果。方法 对１１例由于年龄大,体质差,发现较晚,不能耐受麻醉和手术的中晚期膀胱肿瘤患,采用了动脉插管化疗,结果 １１例患治疗后平均存活时间为２６．２±１３．１个月,１年生存率为８１．８％,总有效率为９０．９％,不良反应轻微,结论 动脉插管化疗是目前治疗中晚期膀胱肿瘤的一种较好方法。     

浅表性膀胱癌的灌注治疗

膀胱癌是泌尿系统最常见的恶性肿瘤之一，其中70％～80％是以反复复发为特点的浅表性膀胱癌。防止肿瘤发生、进展和侵袭转移是降低膀胱癌复发率和病死率的关键。对浅表性膀胱癌灌注治疗的研究进展进行综述。     

Neoadjuvant and adjuvant chemotherapy in bladder cancer

State of the art treatment for invasive bladder cancer is cystectomy. Intensive clinical investigation has been performed in the last years about the role of neoadjuvant and adjuvant chemotherapy. Although neoadjuvant treatment seems not to increase long-term survival, it seems to play a role in the possibility of bladder preservation strategies. Adjuvant chemotherapy, in high-risk patients, seems to improve disease-free survival and time to progression. Nevertheless, new prospective studies should be performed to clarify its role in improving survival.      

Phase I study of combination chemotherapy using sorafenib and transcatheter arterial infusion with cisplatin for advanced hepatocellular carcinoma

The aims of this study were to evaluate the frequency of dose‐limiting toxicities and to find the recommended dose of combination chemotherapy with sorafenib and transcatheter arterial infusion (TAI) using cisplatin for patients with advanced hepatocellular carcinoma (HCC), for whom surgical resection, local ablation therapy, or transcatheter arterial chemoembolization were not indicated. Patients received 800 mg sorafenib daily. Cisplatin was given at one of three dosages (level 1, 35 mg/m²/cycle; level 2, 50 mg/m²/cycle; and level 3, 65 mg/m²/cycle) from feeding arteries to the HCC. The treatment was repeated every 4–6 weeks up to a maximum of six cycles, until there were signs of tumor progression or unacceptable toxicity. The dose‐limiting toxicities experienced by the 20 enrolled patients were grade 4 increased aspartate aminotransferase at level 1, grade 3 gastrointestinal hemorrhaging at level 1, and grade 3 hypertension at level 3. The common drug‐related adverse events that were of severity grade 3 or 4 included the elevation of aspartate aminotransferase (30%), alanine aminotransferase (20%), amylase (30%), and lipase (30%). Partial response was seen in four patients (20%), and 13 patients (65%) had stable disease. The median overall survival and progression‐free survival were 9.1 and 3.3 months, respectively. The combination of sorafenib at 800 mg/day with TAI of cisplatin at 65 mg/m²/cycle was determined to be the recommended regimen. A randomized phase II trial of sorafenib alone versus sorafenib plus TAI of cisplatin is currently underway. This study was registered at UMIN as trial number UMIN000001496.     

Hepatic arterial infusion of chemotherapy for advanced hepatocellular carcinoma

Treatment of advanced hepatocellular carcinoma (HCC) remains a significant problem for clinicians. Sorafenib, the only approved agent, improves survival rate, but is associated with a low tumor response rate. Alternative approaches for the treatment of advanced HCC are urgently needed. Hepatic arterial infusion of chemotherapy (HAIC) is a promising modality for the treatment of advanced HCC. Since its introduction, there have been improvements in implantable pumps, in catheter implantation and in the convenience and safety of HAIC in general. Numerous clinical studies have shown that HAIC provides moderate therapeutic efficacy with substantially favorable toxicity profiles in selected patient groups with advanced HCC. However, the lack of large randomized studies means that HAIC is not yet a well‐established treatment for advanced HCC. We believe there is an urgent need for the further investigation of HAIC for the treatment of advanced HCC.