Prospective study of chemoembolization (CE) of liver metastases from endocrine tumors. A report of 15 cases

Fifteen patients with unresectable liver metastases of endocrine tumors (nine carcinoid tumors and six gastrinomas) were treated with an intraarterial emulsion of iodized oil and adriamycin followed by gelatin sponge particles. Therapeutic efficacy was evaluated in terms of hormone levels and tumor size as measured with computed tomography. Six patients showed a reduction in tumor size, and 4 a response in tumor marker levels. All these metastases were derived from primary carcinoid. All cancer-related syndromes disappeared. There were two major complications. The response in these 6 patients lasted from 2 to 39 months. Metastasis from primary gastrinomas did not respond to CE. These results indicate that chemoembolization is useful palliative therapy for patients with hormone-secreting tumors of the liver, particularly in carcinoids Correspondence to: P. Legmann     

DEB-TACE治疗神经内分泌肿瘤肝转移的疗效初探

目的 初步探讨经动脉载药微球化疗栓塞(DEB-TACE)治疗神经内分泌肿瘤(NEN)肝转移的初步疗效及安全性.方法 回顾性分析2019年3月至2020年1月在介入科治疗的27例NEN肝转移患者的临床资料,原发灶位于胰腺20例,十二指肠3例、直肠4例.术前均经病理学确诊.其中12例接受DEB-TACE治疗(DEB-TAC...     

An initial clinical study on the efficacy of cisplatin-releasing gelatin microspheres for metastatic liver tumors

Purpose

To evaluate the antitumor effect and side effects of cisplatin-releasing gelatin microspheres (Cis-GMSs) for metastatic liver tumors.

Methods

Cis-GMSs that degraded over 14 days were employed. The subjects comprised a total of nine cases. Transcatheter hepatic artery embolization (TAE) using Cis-GMSs (Cis-GMSs-TAE) was performed 13 times in total. Six cases, each containing one to five tumors in a single segment to an entire lobe were treated by Cis-GMSs-TAE. In the remaining three cases with six or more metastatic liver tumors, the right and left lobes were treated by Cis-GMSs-TAE at a 2-week interval.

Results

There were two complete response (CR), one partial response (PR) and six stable disease (SD) cases. The response rate was 33.3%. The average rate of reduction in tumor diameter was 32%. Disappearance of metastatic liver tumors was observed in only two of the nine cases. As for side effects and complications, post-embolization syndrome was observed in eight cases, but no severe complications such as cholangitis or liver abscess were observed.

Conclusion

Considering the mild side effects by Cis-GMSs-TAE, it is suggested that Cis-GMSs-TAE should be tried at least once as topical therapy for metastatic liver tumors when the response to systemic chemotherapy and other treatments is not satisfactory.     

胃肠道间质瘤肝转移介入治疗疗效分析

目的观察经肝动脉化疗栓塞(TACE)治疗胃肠道间质瘤(GIST)肝转移的临床疗效。方法对4例胃肠道间质瘤肝转移患者共19个病灶,病灶直径2～5cm,经肝动脉灌注FuDR、CDDP、EPI-ADM,用超液化碘油和明胶海绵作动脉栓塞,每例平均2～4次。结果DSA显示GIST肝转移灶动脉血供丰富,染色明显,经TACE治疗后,肝转移灶未见缩小,碘油较快被清除,4例患者无CR或PR,2例改服伊马替尼有效。结论有限的病例显示TACE治疗胃肠道间质瘤肝转移未见明显疗效。     

胃肠道肿瘤肝转移血管内介入治疗效果分析

目的：探讨多次动脉化疗栓塞术(TACE)治疗胃肠道肿瘤肝转移的效果。方法：43例胃肠道肿瘤肝转移患者行肝动脉化疗栓塞术。均于第三次治疗后2—4个月复查，观察瘤灶反应。结果：本组病例中完全缓解7．0％(3／43)，部分缓解44．2％(19／43)，无变化25．6％(11／43)，进展23．3％(10／43)，有效率51．2％(22／43)。6个月、12个月、2年生存率分别为92．6％、70．4％、14．8％。结论：动脉化疗栓塞法治疗胃肠道肿瘤肝转移有确切疗效，对于乏血供转移灶亦有良好效果。     

Colorectal liver metastases: regional chemotherapy via transarterial chemoembolization (TACE) and hepatic chemoperfusion: an update

Liver metastasis is one of the main problems encountered in colorectal cancer management as the liver is the most common metastatic site. Several treatment options are available, among which transarterial chemotherapy has proved effective in achieving some local tumour control, improving the quality of life through symptomatic control as well as survival time. The present paper is intended to provide an overview of the techniques, indications and results of regional chemotherapy, which comprises transarterial chemoembolization (TACE) and chemoperfusion. This treatment approach has symptomatic, palliative, adjuvant and potentially curative objectives. We reviewed the studies involving TACE and chemoperfusion of colorectal liver metastases during the last few years to update the previous reviews published on this subject. The results achieved were so variable, due to the variations in patient selection criteria and regimens used between the different studies. The median survival ranged from 9 to 62 months and the morphological response ranged from 14 to 76%. Technical aspects, results, and complications of this modality will be demonstrated with a detailed analysis and comments.     

Uptake of mangafodipir trisodium in liver metastases from endocrine tumors

The purpose of the study was to investigate retrospectively whether mangafodipir trisodium (MnDPDP) can enhance the liver metastases from endocrine tumors. Thirteen patients with endocrine tumors and liver metastases underwent T1-weighted spin-echo (SE) and turbo gradient-echo (GRE) MRI conducted before and 20 to 60 minutes after iv infusion of MnDPDP. Additional 24-hour-delay scans were performed in 8 of 13 patients. MR signal intensity (SI) was measured in liver parenchyma and metastases, which was then related to that of paraspinal muscle. A total of 30 lesions on precontrast and postcontrast images and 18 lesions on 24-hour-delay images were measured. An enhancement by 49% in SE and 40% in GRE images (P = .0001) was observed in tumor tissues after MnDPDP infusion. In 24-hour-delay images, the SI of the lesions remained relatively high, but in liver parenchyma, it decreased significantly, and the tumor-liver tissue contrast was reduced.     

射频消融联合肝动脉化疗栓塞治疗肝转移癌

目的 评价射频消融术(RFA)联合肝动脉化疗栓塞术(TACE)对于肝转移癌的治疗效果.方法 搜集2005年3月至2010年10月36例肝转移癌患者的临床资料进行分析,其中男22例,女14例;年龄42～82岁,平均(63±12)岁;肿瘤最大径1.5～12.0 cm,平均(4.5±2.4) cm.其中单发转移灶29例,多发转移7例,共47个病灶.患者均为全身化疗失败或无法耐受,且无其他脏器转移证据者.术前CT扫描,对于富血供者先行TACE,术后3周内行RFA;对于乏血供者,先行RFA,术后3周内行TACE.对于多个病灶,采取分次逐一治疗.术后每个月行B超复查及肝功能、血象、肿瘤标记物检查,每3个月行腹部CT增强扫描1次.对于随访过程中肿瘤的局部残存及复发,在可能的前提下仍行RFA+TACE治疗.根据治疗后的影像表现分为病灶完全消融组和病灶部分消融组2个亚组,完全消融组不再进行任何治疗,定期随访观察;部分消融组如无法行进一步RFA治疗,则根据患者情况定期行TACE治疗.随访终点事件为患者死亡.对所有患者的整体生存期及两个亚组的生存期采用SPSS 18.0统计分析软件,Kaplan-Meier方法进行统计分析.结果 RFA全部采用经皮途径在局部麻醉结合静脉基础麻醉下完成,无严重并发症发生.16例患者经过1次或多次联合治疗后达到局部病灶完全消除(病灶完全消融组);20例患者病灶部分消除(病灶部分消融组).随访时间10～40个月,平均(25±10)个月.死亡23例,至今存活13例.中位生存期27个月(95%可信区间:24～32个月).至观察终点1、2、3年生存率分别为91.7%(33/36例)、55.5%(20/36例)、36.1%(13/36例).病灶完全消融组和部分消融组的3年生存率分别为75.0%(12/16例)和5.0%(1/20例),差异有统计学意义(P<0.01).结论 RFA+TACE可以有效控制肝转移癌患者肝内病变的进展,延长患者生存期.争取病灶的完全消融是提高疗效的关键.

Abstract：

Objective To investigate the efficacy and safety of radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) for treating of hepatic metastasis. Methods From Mar. 2005 to Oct. 2010, 22 males and 14 females with hepatic metastasis were enrolled in this study. Mean age of the patients was 63±12 (42-82) years. Tumor size was (4.5±2.4) cm (min.1.5 cm, max. 12.0 cm). Totally 47 lesions were treated with single metastasis in 29 cases and multiple ones in 7 cases. All cases were failed to chemotherapy or could not stand for the side effect of chemotherapy. Contrast enhanced CT scan was given to all patients before RFA+TACE. For lesions with rich blood supply, TACE was given and then RFA. For those with poor blood supply, RFA was given first and then TACE. For multiple lesions, RFA+TACE was given one by one for each lesion. As for follow up, ultrasound and blood check was given monthly. Enhanced CT scan was given every 3 month. For residual lesions or recurrent lesions, RFA+TACE were given repeatedly. The whole patients was divided into two groups according to the image follow up including complete ablation group and partial ablation group. For complete ablation group, no further treatment was given. For partial ablation group, if it was not suitable for further RFA, repeated TACE was given there after. The end point of follow up was death event. Survival of the whole group and the two subgroups was analyzed statistically by Kaplan-Meier method. Results All RFA procedures was given under intravenous anesthesia and local anesthesia, no severe complication was noted. Lesions in 16 patients were completely ablated after single or multiple sections of RFA+TACE. Twenty patients were in the partially ablated group. Follow up time was 25±10 (10-40) months. Twenty-three patients died and 13 kept alive during the follow up time. The estimated median survival time was 27 month (95%CI: 24-32 months). Survival ration at 1, 2, 3 years for the whole group was 91.7%(33/36),55.5%(20/36),36.1%(13/36) for the whole group. The 3 years survival for complete and partial ablation group was 75.0%(12/16),5.0%(1/20),there was a significant difference between the two groups(P<0.01). Conclusion For patients with hepatic metastasis, RFA+TACE can effectively control the local lesion. Complete ablation is the key point for a better survival.     

Transpulmonary chemoembolization (TPCE) as a treatment for unresectable lung metastases

To evaluate tumor response after treating unresectable lung metastases with transpulmonary chemoembolization (TPCE) in palliative intention. From 2001 to 2005, 52 patients (mean: 59.8 years; 32 males/20 females) suffering from 106 unresectable lung metastases (mean:6 metastases/patient; range,1–21) were treated with 2–10 TPCE-sessions (mean: 3.3 sessions/patient). Metastases originated from primaries, including colorectal carcinoma (n = 20), breast cancer (n = 6), renal cellular carcinoma (n = 5), thyroid cancer (n = 4), cholangiocellular carcinoma (n = 2), leiomyosarcoma (n = 2), and others (n = 13). Tumor-feeding pulmonary arteries were selectively probed after puncturing the femoral vein, and administering 10 ml lipiodol, mitomycin C, and microspheres (Spherex) each via balloon catheter over pulmonary approach. During therapy, follow-up was accomplished at 4-week intervals using unenhanced and contrast-enhanced CT. After sequential therapy, follow-up was performed every 3 months for a period of 6 months up to 2.25 years. All patients tolerated the treatments well without major side effects or complications. In 24% (n = 13) moderate to high lipiodol uptake was found, while 75% (n = 39) of the tumors showed a low uptake. According to the RECIST criteria, “partial response” was achieved in 16 cases, “stable disease” in 11 cases, and “progressive disease” in 25 cases [mean survival: 17 months/median: 21.1 months (Kaplan-Meyer)]. According to these findings, TPCE is a well-tolerated procedure for palliative treatment of unresectable lung metastases.     

小儿实体肿瘤介入治疗进展

小儿肿瘤近年来发病率越来越高,但小儿实体肿瘤的相关研究明显滞后。小儿实体肿瘤以神经系统肿瘤的比例较高,其他实体肿瘤主要为骨肿瘤、肾脏、肝脏等相关肿瘤。神经系统的介入治疗仍未广泛应用,接受介入治疗比例最高的肿瘤为肝细胞癌。介入治疗能够抑制癌组织的生长,联合手术治疗能够明显提高患者的生存期。介入治疗为不能接受手术治疗的患者提供了新的治疗思路,让更多的患者有了更多治疗选择。但是介入治疗在小儿肿瘤的应用中仍有许多问题需要我们在临床工作中继续努力,不断创新。     

选择性肝动脉化疗药物灌注及栓塞治疗肝转移癌

目的 探讨选择性肝动脉化疗药物灌注及栓塞治疗肝转移癌的价值。材料与方法对122例失去手术机会的肝转移癌患者，采用经股动脉穿刺，选择性肝动脉插管灌注化疗药物(ADM，MMC，CDDP，5-FU)，并用ADM及碘化油乳化后检塞肝动脉。结果近期疗效以CT检查结果作为评价标准，总有效率为54％(66／122)，平均生存期22．2个月。0．5、1、2、3年生存率分别是98．3％、80．4％、40．9％、10．6％。结论经肝动脉化疗药物灌注及栓塞治疗是失去手术机会的肝转移癌患者的一种安全、有效的姑息性治疗方法，其不仅能提高疗效，而且能改善患者的生活质量。     

双介入治疗肝肿瘤的临床应用

目的探讨采用穿刺引流抽吸肝肿瘤中心坏死物(DTND)和经动脉化疗栓塞(TACE)治疗肝肿瘤的疗效。方法明显液化坏死的原发性巨块型肝癌4例,消化道间叶细胞来源肝转移瘤1例。患者先行肝TACE术,随后行DTND。4例行坏死物持续负压引流,1例反复多次抽吸。在引流或抽吸同时向瘤腔内注入无水乙醇。结果4例持续引流者肿瘤缩小明显,抽吸者肿瘤略缩小。5例均未出现并发症。结论PTND结合肝TACE术是治疗液化坏死肝肿瘤安全、可行的方法。     

肝动脉热化疗及热碘油栓塞治疗结肠直肠癌肝转移

目的评价肝动脉热化疗及热碘油栓塞治疗结肠直肠癌肝转移瘤的效果。方法68例结肠直肠癌肝转移瘤患者分为2组,采用肝动脉热化疗及热碘油栓塞治疗的34例作为热疗组,采用常温动脉化疗及碘油栓塞治疗的34例作为常规组。结果热疗组有效率为65％（22／34）,常规组有效率为32％（11／34）,两组间差异有统计学意义。两组术后肝功能变化差异无统计学意义。6、12、18和24个月生存率热疗组分别为100％、82％、44％和18％,常规组分别为91％、47％、15％和6％。结论肝动脉热化疗及热碘油栓塞治疗结肠直肠癌肝转移是一种有效的方法,而对肝功能无明显的损害。     

胃肠道间质瘤肝转移灶的18F-FDG PET/CT显像特点

目的分析胃肠道间质瘤(GIST)肝转移灶¹⁸F-脱氧葡萄糖(FDG)PET/CT显像特点,以提高诊断准确性。方法回顾性分析2013年5月至2019年7月间在福建省肿瘤医院行¹⁸F-FDG PET/CT检查并确诊肝转移的33例GIST患者(男18例,女15例,年龄34~70岁)的临床和影像资料。患者均行¹⁸F-FDG PET/CT早期显像,另有9例后行延迟显像。对患者PET/CT图像行视觉分析,比较病灶与肝本底的放射性摄取,将转移灶分为高代谢、稍高代谢、等或低代谢;计算并比较GIST原发灶与肝转移灶的最大标准摄取值(SUVmax),另分析两者的关系。采用Wilcoxon秩和检验和Spearman秩相关分析数据。结果33例GIST的肝转移患者中,肝转移单发9例,多发24例,共104个病灶。104个肝转移病灶直径为0.8~14.6[2.2(1.5,3.9)]cm,SUVmax为1.4~21.5[3.6(2.4,5.7)]。94.2%(98/104)的病灶边界清楚;65.4%(68/104)的病灶密度均匀(其中2个囊性病灶),34.6%(36/104)的病灶密度不均匀,可见出血、囊变或坏死。PET图像视觉分析中,38.4%(40/104)的病灶为高代谢,26.0%(27/104)的病灶为稍高代谢,35.6%(37/104)的病灶为等或低代谢。24例多发肝转移患者中,79.2%(19/24)同时存在不同代谢水平的病灶。67个代谢增高病灶中,34.3%(23/67)呈均匀代谢,其中13个病灶直径<2.0 cm;65.7%(44/67)呈不均匀代谢,其中36个病灶直径≥2.0 cm。15例GIST同时性肝转移患者的原发灶与肝转移灶SUVmax[9.2(6.8,14.5)与3.8(2.1,6.0)]间呈中等程度相关(rs=0.556,P<0.01);两者差异有统计学意义(z=-5.098,P<0.01)。延迟显像中,13/15的等或低代谢肝转移病灶转为稍高代谢。结论GIST肝转移¹⁸F-FDG PET/CT显像通常边界清楚,常合并囊变、出血或坏死;代谢表现多样;延迟显像有助于低代谢GIST肝转移病灶的诊断。     

三氧化二砷-碘油化疗栓塞对兔肝移植瘤转移及与血管形成关系的研究

目的观察三氧化二砷（ As2O3）-碘油经肝动脉化疗栓塞对兔VX2肝移植瘤生长及转移的影响及与血管形成的关系。方法 48只家兔肝内肿瘤种植后2周，完全随机法分为4组，经肝动脉插管分别给予不同处理，实验设生理盐水灌注组、单纯碘油栓塞组、阿霉素．碘油栓塞组及 As2O3-碘油栓塞组。治疗后1周，免疫组织化学测定肿瘤区的微血管密度（MVD），治疗后3周，测量计算肝移植瘤的体积、坏死面积，观察肝内、双肺及其他器官肿瘤转移的发生率。结果 治疗后1周，各组MVD分别为（21．8±5．3）、（23．4±3．9）、（22．4±4．50）、（14．3±3．4）条／400倍视野（F=11．246，P=0．000）， As2O3-碘油栓塞治疗组与其他组相比差异有统计学意义；肿瘤植入后5周，各处理组肿瘤体积分别为（35．5±7．1）、（21．2±8．3）、（20．7±9．1）、（11．8±3．7）cm^3（F=21．203，P=0．000）。单纯碘油栓塞组、阿霉素一碘油栓塞组及 As2O3-碘油栓塞组与生理盐水灌注组相比差异有统计学意义（q值分别为6．723、6．940、11．119，P〈0．05）， As2O3-碘油栓塞组与单纯碘油栓塞及阿霉素-碘油栓塞组相比差异有统计学意义（g值分别为4．398、4．178，P值均〈0．05）；各组肿瘤坏死面积间差异无统计学意义（F=1．284，P=0．292）； As2O3-碘油栓塞治疗组双肺转移结节数目少于其他组（H=14．983，P=0．002），结节直径小于其他组（F=4．580，P=0．007），差异有统计学意义。腹腔转移淋巴结记分显示 As2O3-碘油栓塞治疗组腹腔淋巴结转移少于其他组（H=9．148，P=0．027）。双肺转移结节的数目、直径及腹腔转移淋巴结与肿瘤的微血管密度呈正相关（P〈0．05）。结论 As2O3-碘油联合经肝动脉栓塞治疗，抑制兔肝移植瘤的生长，抑制肿瘤的肺及腹腔淋巴结转移，其抑制转移的机制可能与抑制肿瘤血管形成有关。     

吐温80温热灌注化疗栓塞治疗转移性肝癌的临床研究

目的　探讨吐温 80温热灌注化疗栓塞治疗转移性肝癌的可行性。方法　选择转移性肝癌 32例 ,分为吐温 80温热灌注化疗栓塞组 (15例 ,治疗组 )和常规化疗栓塞组 (17例 ,对照组 )。治疗组采用加温至 6 2°C的吐温 80、化疗药液和碘油进行化疗栓塞。对照组在室温下用常规化疗栓塞治疗。结果　治疗组的肿瘤生长率 (- 0 .4 1± 0 .2 5 )小于对照组 (- 0 .12± 0 .4 5 ) ,差异有显著性 (P <0 .0 5 )。近期有效率于治疗组为 6 0 % ,对照组为 4 1/2 % ,差异无显著性 (P >0 .0 5 )。治疗组中 ,不良反应轻度 3例(2 0 % ) ,中度 8例 (5 3.3% ) ,重度 4例 (2 6 .7% ) ;对照组中轻度 4例 (2 3.5 % ) ,中度 10例 (5 8.8% ) ,重度3例 (17.7% ) ,两者差异亦无显著性 (P >0 .0 5 )。结论　经导管肝动脉的吐温 80温热灌注化疗栓塞 ,是治疗转移性肝癌的安全有效的方法。     

射频消融术联合肝动脉化疗栓塞及西妥昔单抗治疗结直肠癌肝转移的疗效评价

目的 探究射频消融术(RFA)联合肝动脉栓塞化疗术(TACE)及西妥昔单抗(cetuximab)治疗结直肠癌肝转移的临床疗效.方法 回顾性分析2010年1月-2014年1月49例结直肠癌肝转移患者,分为治疗组(RFA+TACE+cetuximab)23例和对照组(TACE+cetuximab)26例,观察两组患者治疗后实体瘤疗效、1年总生存率(OS)、1年无进展生存率(PFS)及不良反应的情况.结果 治疗组的完全缓解率达到73.9％(17/23),明显优于对照组的26.9％(7/26),差异有统计学意义(P＜0.05).治疗组及对照组的OS差异无统计学意义(P＞0.05);但治疗组的1年PFS为52.2％,优于对照组的23.1％,差异有统计学意义(P＜0.05).结论 对于无法手术的结直肠癌肝转移患者,RFA联合TACE及西妥昔单抗治疗的近期疗效及1年PFS优于单纯TACE联合西妥昔单抗治疗,具有肿瘤完全坏死率高、肝内复发率低的优点.     

肝动脉化疗栓塞结合门静脉癌栓内注药治疗原发性肝癌伴门静脉癌栓临床疗效的初步观察

目的 探讨肝动脉化疗栓塞结合经皮穿刺门静脉癌栓内注药治疗原发性肝癌伴门静脉痛栓的临床价值.方法 30例不能手术切除病灶的原发性肝癌伴门静脉癌栓患者,采用完全随机方法分成A、B组,A组14例,B组16例.治疗前A、B组患者的肝功能Child-Push分级A级均为9例,B级分别为5例和7例(χ~2=0.201,P>0.05);Ⅱ型癌栓A组8例,B组9例,Ⅲ型A组6例,B组7例(χ~2=0.002,P>0.05);A、B两组患者术前丙氨酸氨基转移酶(ALT)中位数分别为58.7和70.5 U/L(W=191.5,P>0.05);总胆红素(TBIL)中位数分别为21.4和21.7 μmol/L(W=203,P>0.05);白蛋白(ALB)中位数分别为35.3和37.5 g/L(W=214,P>0.05);甲胎蛋白(AFP)中位数分别为680和873μg/L(W=179.00,P>0.05),两组相比差异均无统计学意义.A组以肝动脉化疗栓塞治疗肝内原发肿瘤灶,经皮穿刺门静脉癌栓内注药治疗门静脉癌柃;B组单纯肝动脉化疗栓塞治疗.采用Kaplan-Meier计算两组患者的中位生存期,log-rank法检验组间差异.结果 患者治疗后的中位生存期,A组14.0个月、B组4.0个月,两组差异具有统计学意义(χ~2=11.728,P<0.01).患者3、6和12个月的生存数,A组分别为11、10和7例,B组分别为10、3、0例.2组均未见与治疗相关的严重不良反应.结论 与单纯肝动脉化疗栓塞相比,肝动脉化疗栓塞结合经皮穿刺门静脉癌栓内注药治疗,可以显著延长伴有Ⅱ、Ⅲ型门静脉癌栓的原发性肝痛患者的中位生存期.     

肝动脉内持续灌注治疗结直肠癌术后肝转移瘤

目的：探讨5－氟尿嘧啶（5－Fu)／甲酰四氢叶酸钙（CF）经肝动脉持续性灌注治疗结直肠癌肝转移的临床疗效。方法：62例无外科手术指征的结直肠癌肝转移患者，其原发病灶均已作根除术，依据肝动脉内化疗方式不同分为2组：A组32例，采取经皮肝动脉内植入药盒，术后经药盒每个月连续5d持续灌注5－Fu／CF及地塞米松；B组30例，采取每个月1次肝动脉插管大剂量灌注5－Fu/CF。结果：A，B组有效率（完全缓解＋部分缓解）分别为50．0％和23．3％（P＜0．05）。A组1年，2年生率分别为65．6%，39．3％，B组分别为36．7％，11．5％（P＜0．05）。A组1年，2年生存率分别为65．6％，39．3％，B组分别为36．7％，11．5％（P＜0．05）。A组生存质量明显改善，肝，胆，胃十二指肠毒性均较B组低。结论：经药盒肝动脉持续性灌注5－Fu/CF并配合地塞米松治疗结直肠癌肝转移可明显改善患者生存质量，提高生存率。     

动脉热灌注化疗联合超选择栓塞治疗不可切除结直肠癌肝转移的临床研究

目的：研究动脉热灌注化疗联合超选择栓塞治疗不可切除结直肠癌肝转移的效果。 方法：选取2014年1月—2016年7月我科诊治的39例结直肠癌肝转移患者,分为2组,研究组（22例）在肠系膜上动脉、肝固有动脉以51℃灌注化疗1 h,然后超选择至肝脏病灶的供血动脉,进行化疗栓塞。对照组（17例）接受传统的肝动脉化疗栓塞（TACE）治疗。比较2组的客观有效率、临床获益率及1年生存率。同时记录并比较两组的不良反应。 结果：两组的客观有效率无统计学差异（27.3% vs. 23.5%,P>0.05）,临床获益率也无统计学差异（81.8% vs. 76.5%,P>0.05）。但研究组的1年生存率显著高于对照组（63.2% vs. 46.7%,P<0.05）。两组都未出现血管痉挛、闭塞等特殊并发症。 结论：动脉热灌注化疗联合超选择栓塞治疗不可切除结直肠癌肝转移的远期效果优于传统TACE。