卡铂碳包铁纳米笼壳聚糖纳米球靶向治疗大鼠移植性肝癌的初步研究

目的 观察卡铂碳包铁纳米笼壳聚糖纳米球（C-Fe@CN-CN）对大鼠移植性肝癌的靶向治疗效果.方法 将24只移植性肝癌大鼠按数字表法随机分为4组,每组6只,A组注入0.9％NaCl溶液,为对照组;B组注入卡铂0.9％NaCl溶液;C组注入C-Fe@CN-CN 0.9％NaCl溶液分散液,肿瘤部位不施加磁场;D组注入C-Fe@CN-CN 0.9％NaCl溶液分散液,肿瘤部位施加磁场30 min.开腹行肝动脉插管给药,给药后第7天,再次开腹,完整切除肿瘤,测量肿瘤质量和体积,计算瘤重抑制率.留取肿瘤标本,观察肿瘤病理变化和纳米球沉积情况.结果 移植性肝癌大鼠接受不同剂型卡铂治疗后,肿瘤质量和体积的增长均被显著抑制.A、B、C、D组的肿瘤质量分别为（0.85±0.12）、（0.61±0.10）、（0.48±0.09）、（0.33±0.06）g,差异有统计学意义（P＜0.05）;B、C、D组的瘤重抑制率分别为28.9％、43.4％、61.7％.A、B、C、D组的肿瘤体积分别为（1.06±0.24）、（0.72±0.10）、（0.50±0.07）、（0.28±0.05） cm3,差异有统计学意义（P＜0.05）.D组6只大鼠肿瘤组织病理切片显示肿瘤组织重度坏死,坏死组织中有C-Fe@CN-CN相互聚集;C组5只中度坏死,1例重度坏死;B组4只中度坏死,2例轻度坏死;A组6只均为轻度坏死.结论 C-Fe@CN-CN在体内对大鼠移植性肝癌具有优越的靶向治疗效果.     

比较卡铂盆腔动脉化疗栓塞与单纯动脉灌注化疗的动物实验研究

背景与目的:动脉灌注化疗与动脉栓塞可提高肿瘤组织局部药物浓度和延长药效时间,但哪一种方法在临床药代动力学上更有优势,目前尚无定论.本研究的目的是比较超液态碘油卡铂盆腔动脉化疗栓塞与卡铂单纯动脉灌注化疗后,犬子宫组织及血浆中铂(Pt)离子浓度的分布.方法:选择实验用雌犬14只,随机分为盆腔动脉化疗栓塞组(A组)7只和盆腔动脉单纯灌注组(B组)7只.A、B组分别将卡铂(12 mg/kg)溶于超液态碘油(0.2 ml/kg)和5%葡萄糖(0.2 ml/kg)中,注入双髂内动脉.然后在不同的时间点分别取子宫组织及静脉血,用原子吸收光谱法测定上述标本内的Pt离子浓度.结果:(1)A、B两组子宫组织Pt离子浓度曲线均为单峰曲线,峰值分别为(215.0±17.6)μg/g和(211.3±40.1)μg/g,两组无显著性差异(P＞0.05).(2)A、B两组子宫组织Pt离子药时曲线下面积(AUC0～240min)分别为(13.9±3.9)mg·min·g-1和(5.9±0.6)mg·min·g-1,两组有显著性差异(P＜0.01).(3)A、B两组血浆中Pt离子峰值分别为(8.7±12.5)μg/g和(16.7±3.6)μg/g,AUC0～240min分别为(0.5±0.1)mg·min·g-1和(1.2±0.4)mg·min·g-1,均有显著性差异(P＜0.01).结论:与卡铂单纯动脉灌注化疗相比,动脉化疗栓塞能有效提高并保持局部组织内的Pt浓度,降低血浆中Pt浓度,从而提高局部化疗效果、降低全身毒副作用.     

荷VX2移植性乳腺癌兔区域淋巴组织靶向化疗的实验研究

目的:研究对荷VX2乳腺癌兔实施区域淋巴组织靶向化疗后的局部淋巴结药物浓度及治疗效果。方法:40只雌性新西兰兔随机分为A、B、C、D4组,每组10只,VX2肿瘤组织块悬液注射法建立乳腺癌模型,腋淋巴结最大径达到5mm时开始治疗。A、B组分别给予肿瘤周围皮下注射卡铂活性碳混悬液(carboplatinactivatedcarbonsuspension,CPCH)或卡铂水溶液(carboplatinsolution,CPSol);C、D组分别经耳缘静脉注射CPSol或生理盐水。A、B、C组每次治疗药物剂量5mg/kg,每48h重复给药1次,治疗3次,48h后切除肿瘤、腋窝淋巴结及所有发现的远处转移灶,测量治疗前后肿瘤及淋巴结体积变化,原子吸收光谱法(atomicabsorptionspectrometry,AAS)测定卡铂浓度,常规病理切片观察肿瘤及转移灶坏死情况,RTPCR检测肿瘤组织增殖细胞核抗原(PCNA)。结果:与静脉或局部注射CPSol相比,局部注射CPCH可明显增加淋巴结内的药物浓度,并对淋巴结癌转移灶表现出更为显著的疗效,淋巴结增长减缓,淋巴结转移癌细胞大量死亡,PCNA表达降低。静脉注射CPSol可有效抑制乳腺或远处转移灶内的癌细胞增殖,而局部注射CPSol或CPCH无此效果。结论:区域淋巴组织靶向化疗对乳腺癌淋巴途径转移是一种有效的治疗手段,可辅助用于全身治疗。     

抗癌药物磁性微球靶向给药的药代动力学研究

目的　探讨阿霉素磁性蛋白微球 (ADM MAMs)靶向给药后动物体内靶区组织中的药代动力学状况。方法　将 10 0只Wastar大白鼠分为A组 (消化道给药靶向组 ) ,B组 (消化道给药非靶向组 ) ,C组 (尾静脉给药靶向组 ) ,D组 (尾静脉给药非靶向组 ) ,每组 2 4只动物 ,应用荧光分光光度法检测并比较每组大白鼠胃壁、肝脏组织及门静脉血液中阿霉素的含量。结果　靶向组大白鼠的胃壁、肝脏组织及门静脉血液中阿霉素的浓度 ,明显高于非靶向组相应组织和血液中的药物浓度 ,且维持时间长 (P <0 .0 1)。结论　ADM MAMs联合外磁场的靶向给药方法可使靶区胃壁、肝脏组织及门静脉血液中的药物浓度长时间维持在较高水平 ,为临床预防及治疗胃癌肝转移提供了实验依据。     

荷瘤小鼠静脉注射洛铂和顺铂后药物浓度的变化规律

目的研究洛铂和顺铂在小鼠血浆、肾脏和肿瘤内的药物浓度随时间变化的规律,为放疗增敏提供实验数据。方法 70只C57BL/6近交系Lewis肺癌荷瘤小鼠随机分组,按10mg药物/kg体重经尾静脉分别给小鼠注射药物（洛铂或顺铂）,给药后在0.5、2、4、24、48、72、96 h分别将小鼠处死获取血液和组织标本（肿瘤和肾脏）,应用ICP-MS方法测定标本铂含量。结果洛铂和顺铂的血浆药时曲线均符合三室模型,半衰期分别为51.139h和35.583h,洛铂在血浆中的清除速率大于顺铂[0.532L/（h.kg）对0.192 L/（h·kg）];洛铂和顺铂在肿瘤组织的浓度均在给药后迅速达到最大[（2.79±0.35）μg/g对（4.78±1.11）μg/g],然后迅速下降,在4 h后分别降至0.99±0.21μg/g和3.39±0.55μg/g,在96 h肿瘤中仍有药物存在,浓度分别为0.23±0.05μg/g和1.41±0.71μg/g。肿瘤药物浓度与血浆药物浓度呈对数相关,Rsq分别为0.948和0.837。结论洛铂和顺铂在小鼠体内静脉给药后半衰期长,肿瘤内药物浓度在给药后很快达到最大,在4 h降至平台期,96 h仍有药物存在,顺铂在肿瘤内的浓度高于洛铂;洛铂在小鼠体内的清除速率快于顺铂;可以通过检测血浆中的洛铂和顺铂浓度来估算肿瘤内的药物浓度。     

乳腺癌淋巴化疗与静脉化疗后腋窝淋巴结药物浓度的比较

背景和目的:淋巴结状态是乳腺癌重要的预后因素之一,区域淋巴组织靶向化疗是近几年出现的针对高淋巴转移倾向肿瘤的治疗方法。本研究检测乳腺癌患者淋巴化疗(lymphaticchemotherapy,LC)后腋窝淋巴结内的药物浓度,并与静脉化疗(intravenouschemotherapy,VC)作对比,以确定LC能否有效提高区域淋巴结内抗癌药物的聚积。方法:60例乳腺癌患者随机分为LC组和VC组,每组30例,所有患者均于术前穿刺活检明确诊断。LC组在癌灶周围皮下注射卡铂鄄活性炭混悬液5mg/ml,VC组给予同等剂量卡铂水溶液静脉化疗。给药后1、12、24、36、48h分别行乳腺癌改良根治术,每组每个时间点各6例患者。术中常规清扫腋窝淋巴结并送病理检查,原子吸收光谱法(AAS)测定淋巴结内卡铂浓度。结果:术中共切除淋巴结275枚,其中LC组154枚,VC组121枚。共有23例(38.3%)患者的146枚(53.1%)淋巴结发现癌转移。LC组给药后1、12、24、36、48h腋窝淋巴结中卡铂浓度分别为(11.82±3.50)、(23.58±7.34)、(18.22±4.93)、(16.70±5.15)、(14.62±4.29)μg/g,VC组在给药后1、12、24、36h分别为(0.06±0.02)、(0.11±0.05)、(0.10±0.02)、(0.05±0.02)μg/g,给药后48h淋巴结内未检测出卡铂,两组间差异有极显著性(P<0.001)。淋巴结药物浓度与癌转移之间无明显     

凋亡诱导因子介导顺铂诱导的肾小管上皮细胞凋亡

目的 研究凋亡诱导因子(AIF)在顺铂诱导肾小管上皮细胞HK-2凋亡中的作用.方法 采用Western blot法和荧光实时定量聚合酶链反应(PCR)分别检测不同浓度(0、25、50、100、150、200 μmol/L)和不同时间(0、3、6、9、12 h)顺铂作用下,体外培养HK-2细胞中AIF蛋白和mRNA表达.采用免疫荧光染色检测顺铂作用下HK-2细胞AIF表达分布.采用原位末端标记(TUNEL)法和流式细胞仪检测泛caspase抑制剂和AIF靶向siRNA对顺铂作用下HK-2细胞凋亡的抑制作用.结果 经不同浓度和不同时间顺铂的作用,HK-2细胞胞质AIF(cAIF)、胞核AIF(nAIF)及其mRNA表达均有不同程度增加.从25 μmol/L顺铂作用12 h和50 μmol/L顺铂作用3 h起,cAlF表达均有升高,分别是对照组的2.3倍(P<0.05)和1.7倍(P<0.01).nAIF表达呈一定浓度和时间依赖性,在150 μmol/L顺铂作用12 h和50 μmol/L顺铂作用9 h达到高峰,分别为25 μmol/L组的4.3倍(P<0.005)和3 h组的3.7倍(P<0.05),nAIF表达与多聚腺苷二磷酸-核糖聚合酶1(PARP-1)剪切片段(cl-PARP)的表达趋势基本一致.AIF mRNA表达在50 μmol/L顺铂作用0-9 h区间呈梯度增加.免疫荧光染色结果显示,经顺铂作用后,部分HK-2细胞发生AIF核转位.泛caspnse抑制剂Z-VAD-FMK和AIF siRNA对顺铂诱导细胞凋亡的抑制率分别为60.1%和39.2%,两者联合应用的抑制作用更加明显.结论 AIF蛋白激活和核转位以及AIF mRNA表达的增加介导了顺铂诱导的肾小管上皮细胞的凋亡,可能为防治顺铂诱导的肾毒性作用提供了新靶点.     

超选择子宫动脉与外周静脉灌注化疗宫颈癌组织内铂浓度的研究

目的:对比卡铂超选择子宫动脉与外周静脉灌注化疗子宫颈癌组织内的药物浓度。方法:选择经病理活组织证实为宫颈癌、且癌灶较大易于取材的患者13例,随机分为超选择子宫动脉灌注化疗组(A组)和外周静脉灌注化疗组(B组),以卡铂300mg/m2,一次性给药。在灌注后0min、10min、20min分别钳取宫颈癌组织,用原子吸收光谱法测定其标本内铂离子浓度。结果:(1)峰值及曲线形态:A组癌组织铂离子浓度的高峰值出现在化疗结束后即刻,且随时间的延长而快速下降,呈一下降曲线;B组峰值出现在化疗后10分钟,随时间的延长呈一弓背向上的下降曲线。前者的峰值是后者的2.79倍,差异有统计学意义(P<0.05)。(2)灌注化疗结束后即刻,A组宫颈癌组织内铂离子浓度是B组的3.75倍,差异有统计学意义(P<0.05)。(3)A组癌组织内铂离子药时曲线下面积(AUC0～20min)是B组的2.10倍,差异有显著意义(P<0.05)。结论:无论癌组织内铂离子峰浓度还是AUC0～20min,超选择子宫动脉灌注化疗组均较外周静脉组明显增高,为评价动脉化疗疗效提供了基础理论依据及临床药代动力学参数。     

顺铂纳米脂质体的小鼠体内药代动力学研究

背景与目的:顺铂是临床常见的具有放疗增敏作用的抗肿瘤药物,但由于其进入体内迅速与血浆蛋白结合而限制了放疗增敏作用的发挥,顺铂的缓释制剂有望延长药物的作用时间,增加疗效,并降低毒性,因此本研究旨在探索长循环纳米脂质体包裹的顺铂在小鼠体内的药物动力学过程。方法:选用C57BL/6N近交系Lewis肺癌荷瘤小鼠80只(肿瘤生长5～7d),分成两组,普通顺铂组(CDDP)和顺铂脂质体组(LDDP),尾静脉分别注射顺铂注射液和顺铂长循环纳米脂质体,剂量均为6mg/kg,于注射后不同的时间取血并处死动物,取肿瘤、肾、肝和肺组织,每个时间点各5只小鼠。采用高效液相色谱法(HPLC)测定游离铂的含量。药动学软件3P97进行数据分析。结果:CDDP组小鼠在注射后游离铂立即达到最高血药浓度3.24μg/ml,并迅速降低,2h后在血液中已经无法检测出游离铂。LDDP组小鼠注射后1h,血浆游离铂达峰浓度13.79μg/ml,是CDDP组峰浓度的4倍多。72h后血药浓度为1.04μg/ml,血中顺铂浓度呈明显的两相性变化过程,初始相顺铂浓度快速下降,半衰期为1.27h,其后第二相顺铂浓度缓慢下降,半衰期为19.47h。结论:顺铂纳米脂质体新配方,使游离铂的血药浓度长时间维持在相对较高的水平。初步达到了长循环,缓释的要求。     

Fe@CN-CN对大鼠移植性肝癌磁靶向热疗效果的观察

目的：研究碳包铁纳米笼壳聚糖微球（Fe@CN—CN）在交变磁场中感应产热规律,观察其对大鼠移植性肝癌（HCC）的磁靶向热疗效果。方法：在体外,观察Fe@CN-CN在高频交变磁场中感应产热规律,确定体内实验条件。36只移植性HCC大鼠随机分为3组（n=12）,A组生理盐水组,B组微球组,C组微球热疗组。C组治疗中记录肿瘤区及周围器官温度,7d后,测量肿瘤体积、质量,计算瘤质量抑制率,病理切片观察肿瘤病理变化和微球沉积情况,比较各组治疗效果。结果：不同浓度、不同电流强度条件下磁流体均能在20min内达到最高温度,产热效应随着两者升高而增强。肿瘤区组织温度i0min内可达到（42．6±0．20）℃,可恒温维持30rain,并显著性高于右肝叶和直肠温度（F=10．925,P=0．000）。C组的瘤质量显著小于其他两组（F=98．830,P=0．000）。C组的瘤质量抑制率为48．5％,是B组的1．5倍;C组的肿瘤体积最小,显著小于其他两组（F=89．086,P=0．000）,仅是A组的42．5％;病理切片显示C组和B组肿瘤组织中均见Fe@CN—CN沉积,C组肿瘤组织呈重度坏死,B组呈中度坏死,A组呈轻度坏死。结论：Fe@CN—CN具有良好的感应产热性能,能靶向定位于大鼠移植性HCC,在交变磁场作用下能有效升高肿瘤组织温度,从而产生显著的治疗效果。     

Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer

In six adult patients with nonresectable liver cancer, as well as in mature New Zealand white rabbits with implanted VX2 carcinoma in the liver, the artery feeding the hepatic lobe with the malignant lesion was ligated, and an oily contrast medium (Lipiodol Ultra-Fluid) was injected into the hepatoproximal lumen of the ligated artery of the liver with carcinoma. The oily contrast medium was detected in all the branches of the artery injected, and thereafter was found only in tumor tissue for 7 days experimentally and for 16 months clinically. Taking advantage of this phenomenon, the therapeutic effect of the injection of an oily anticancer drug (bleomycin oil suspension) into the hepatoproximal lumen of the ligated hepatic artery was investigated in rabbits with VX2 carcinoma of the liver. The mean concentration level of bleomycin in the tumor tissue was 2.4 +/- 0.4 microgram/g 1 week after the injection of bleomycin oil suspension (1.5 mg potency/kg) in three rabbits. However, its concentration level in nontumorous tissue of the liver was undetectably low in two rabbits, but 0.6 microgram/g in the third rabbit. The group of rabbits receiving an injection of bleomycin oil suspension into the ligated artery had a significantly longer mean survival time than those of the experimental group receiving an injection of saline solution of bleomycin into the ligated artery as well as the three other groups treated (P less than 0.02, N = 5 for each group). It may be concluded that an oily anticancer drug injected into the hepatoproximal lumen of the ligated hepatic artery can intensify the anticancer effects of a ligation of the hepatic artery for liver cancer.     

人肝癌移植瘤多药耐药模型的建立及耐药机制的探讨

背景与目的肿瘤多药耐药是肿瘤化疗的主要障碍和研究热点,本研究拟建立人肝癌裸小鼠皮下及肝原位移植多药耐药模型,探讨其生物学特性和耐药机制的异同,为研究体内逆转肿瘤多药耐药提供理想的动物模型。方法人肝癌细胞系HepG2裸鼠肝原位、皮下移植后,用阿霉素腹腔注射诱导耐药。MTT法检测耐药细胞对抗肿瘤药的敏感性,流式细胞仪检测癌细胞膜蛋白P-糖蛋白(P-gp)、多药耐药相关蛋白(MRP)、肺耐药蛋白(LRP)的表达和细胞对罗丹明(R123)的外排作用,逆转录PCR检测耐药细胞中三种膜蛋白mRNA的表达。结果肝原位和皮下移植瘤耐药细胞形态及生物学行为符合人肝癌特征;对多种药物产生较明显的耐药性,其中对阿霉素的耐药倍数分别为26.4和24.6;肝皮下移植和原位移植组耐药细胞膜蛋白P-gp、MRP和LRP的阳性率均增高,分别为(77.3±2.1)%和(78.1±1.9)%,(72.1±4.3)%和(72.7±5.1)%,(31.1±1.0)%和(32.2±1.4)%。多药耐药基因的阳性率也明显增高,细胞对R123的外排作用增强;肝原位移植瘤组与皮下移植瘤组比较,多药耐药性差异没有统计学意义(P>0.05)。结论所建立的裸鼠肝原位及皮下移植瘤多药耐药模型符合人肿瘤多药耐药特征,为研究体内逆转多药耐药提供了理想的动物模型。     

Potentiation of the cytostatic effect of melphalan on colorectal cancer hepatic metastases by infusion of buthionine sulfoximine (BSO) in the rat Enhanced tumor glutathione depletion by infusion of BSO in the hepatic artery

Purpose: Glutathione (GSH) plays an important role in the resistance of tumors to cytostatics. Therefore, depletion of GSH by the GSH synthesis inhibitor buthionine sulfoximine (BSO) has been proposed to enhance the efficacy of certain anticancer agents. We studied the effect of BSO in rats bearing intrahepatically implanted tumors of the CC531 colorectal cancer cell line on the antitumor activity of melphalan (L-PAM). Since these liver tumors tend to derive most of their blood supply from the hepatic artery, we evaluated whether delivery of BSO into the hepatic artery would more selectively decrease GSH levels in the implanted tumor tissue as compared with normal liver and extrahepatic tissues. Methods: Tumor-bearing rats were treated with a 24-h continuous infusion of 0.375 mmol/kg BSO via the jugular vein, immediately followed by a bolus L-PAM (15 μmol/kg; 4.5 mg/kg) infusion via the hepatic artery. Laparotomy was performed on day 14 and 28 after treatment for measurement of the liver tumors. For the evaluation of locoregional administration of BSO, a 24-h continuous infusion of 0.375 mmol/kg BSO was delivered into either the hepatic artery, the portal vein, or the jugular vein in freely moving rats and GSH levels in the tumor, liver, kidney, lung, heart, bone marrow, and blood were measured. Results: BSO infusion via the jugular vein increased the antitumor efficacy of L-PAM injected into the hepatic artery 2-fold as determined at 14 days after treatment. Although infusion of BSO via the hepatic artery depleted GSH more severely in the tumor as compared with jugular vein or portal vein administration, the additional effect was only slight (10%). No difference was observed in any other tissue. Conclusion: GSH depletion increased the cytostatic efficacy of L-PAM 2-fold in vivo as determined at 14 days after treatment. Hepatic artery infusion of BSO translated into a statistically significant, but probably not therapeutically relevant, increase in tumor GSH depletion as compared with the other routes of BSO administration. Received: 21 September 1998 / Accepted: 4 January 1999     

夏枯草及抗炎一号注射液经肝动脉联合灌注治疗大鼠肝癌作用机制的初步探讨

目的:探讨夏枯草及抗炎一号注射液经肝动脉联合灌注治疗大鼠肝癌的作用机制。方法:建立30只二乙基亚硝胺(DEN)诱发大鼠晚期原发性肝癌模型,随机分为中药组、化疗组和盐水组,每组各10只。经胃十二指肠动脉至肝固有动脉分别灌注生理盐水0.5ml、夏枯草注射液0.6g/kg 抗炎一号注射液0.45g/kg、顺铂(DDP)4mg/kg 羟基喜树碱(HCPT)1.5mg/kg 5-氟尿嘧啶(5-FU)34mg/kg。应用流式细胞仪(FCM)检测治疗后各组大鼠肝癌细胞的凋亡情况。结果:盐水组、化疗组和中药组均存在不同程度的细胞凋亡现象,与盐水组比较,中药组和化疗组肝癌细胞凋亡百分率均显著增高(P<0.01),但化疗组和中药组之间无显著性差异(P>0.05)。结论:夏枯草与抗炎一号注射液可诱导大鼠肝癌细胞凋亡,其程度与化疗药物相似。     

Anticancer effects of local administration of mitomycin C via the hepatic artery or portal vein on implantation and growth of VX2 cancer injected into rabbit liver

Rabbits were inoculated with a suspension of VX2 carcinoma cells in the liver, and mitomycin C was given via the hepatic artery or the portal vein for a study of the anticancer effects. Twenty-eight rabbits were killed for preliminary study at 1 h or 1, 3, 7, 9, 12, or 14 days after the inoculation. Another 36 rabbits were divided into three groups. Groups A and B were given the agent (0.5 mg/kg), 1 h after the inoculation and on Days 2, 4, 6, and 8, into the common hepatic artery or the splenic vein, respectively. Group C was not treated after inoculation. The mean numbers of cancer nodules per rabbit in Groups A, B, and C were 11.9, 36.4, and 83.4, respectively, at 12 days after inoculation. The number of cancer nodules of Group A was smallest (P less than 0.025, F test). The means of the total cross-sectional area of tumor nodules in Groups A, B, and C were 32.7, 79.7, and 217.3 mm2, respectively. The total cross-sectional area of the cancer nodules of Group A was smallest (P less than 0.05, F test). These results suggest that the anticancer agents given via the hepatic artery had better effects on early (small) metastatic liver tumor than those via the portal vein.     

Clinical outcome of intra-hepatic arterial infusion therapy for multiple liver metastases from colorectal cancer

Weekly infusion of high-dose 5-FU through the hepatic artery after resection of colorectal cancer was compared with resection alone in patients with multiple liver metastases. Twenty-seven patients (Group I) underwent hepatic artery infusion chemotherapy and 74 patients (Group II) underwent resection alone. The average survival time was 17.9 months in Group I and 8.5 months in Group II. One CR and 7 PR were achieved with arterial infusion therapy and the response rate was 29.6%. One- to three-year survivals were better in Group I than Group II.     

Treatment of symptomatic metastatic cancer to the liver from primary colon and rectal cancer by the intraarterial administration of chemotherapy and radioactive isotopes

Sixty-five patients were referred for treatment with symptoms resulting from metastatic cancer to the liver from the GI tract. Two groups of patients were analyzed. The first group of 40 patients were subjected to a laparotomy and insertion of a catheter into the hepatic artery and a second group had the catheter inserted percutaneously and a bolus of cancer chemotherapeutic agents injected into the catheter. In both groups, chemotherapy in the form of 5-fluorouracil was supplemented by internal irradiation delivered from the intraarterial administration of Yttrium 90 microspheres. Forty percent of the patients who had an indwelling catheter performed at celiotomy manifested an objective response and in 60% a significant subjective improvement occurred. In the 25 patients whose catheter was inserted percutaneously, the response rate was roughly similar, in that 35% demonstrated an objective response and 65% demonstrated a subjective response.     

经药盒系统对晚期肿瘤行化疗栓塞的临床研究

目的：采用介入技术经锁骨下动脉入路皮下植入药盒系统。研究经药盒系统对晚期肿瘤行化疗栓塞的临床疗效。方法：随机分成A、B两组。A组选择化疗栓塞的给药方案，B组选择单纯灌注化疗的给药方案，各20例。结果：两组有效率（CR＋PR）A组为45％，B组为20％（P＜0．05）。1年生存率A组为50％，B组为30％（P＜0．05）。结论：晚期肝癌患者，采用介入技术经锁骨下动脉入路皮下植入药盒系统行化疗栓塞是有效、可行的。     

双泵化疗在大肠癌肝转移中的应用

目的 探讨肝动脉加门静脉灌注化疗（双泵化疗）在大肠癌肝转移中的价值。方法 30例大肠癌肝转移患者术后2周开始接受灌注化疗。其中采用双泵化疗（I组）12例,肝动脉灌注化疗（Ⅱ组）10例,门静脉灌注化疗（Ⅲ组）8例。3组化疗方案的剂量频次均相同。结果 肝转移灶治疗有效率（CR＋PR）Ⅰ组为66．7％,Ⅱ组为60．0％,Ⅲ组为37．5％。0．5,1,2年生存率I组分别为100．0％、75．0％、41．7％;Ⅱ组为90．0％、60．0％、30．0％;Ⅲ组为87．5％、50．0％、25．0％。结论 双泵灌注化疗是大肠癌肝转移治疗和预防的一种有效辅助手段,其疗效优于单纯肝动脉灌注化疗或门静脉灌注化疗。