胃肠癌肝转移经肝动脉栓塞及皮下药盘持续灌注化疗的疗效初探

目的本研究观察经肝动脉栓塞化疗和(或)肝动脉插管持续灌注化疗胃肠癌肝转移的临床疗效。方法18例胃肠癌外科手术后肝转移患者经肝动脉介人治疗共58次,单采取Seldinger法肝动脉内插管皮下埋置药盒持续灌注化疗40次,或先用LOHP100mg加入超液化碘油10～30ml进行肝动脉栓塞化疗再联合肝动脉持续灌注化疗共18次。肝动脉插管灌注的方案:CF100mgdl-5,静脉滴入;奥沙利铂(LOHP)135mg/m2,dl,从皮下药盒处缓慢推入;5-Fu2500mg/m2,dl-5,装入便携式输液泵持续动脉灌注120h。结果总有效率(完全缓解 部分缓解)为66.67%。肿瘤负荷<50%者的有效率为70%,肿瘤负荷>50%者的有效率为37.5%,明显高于肿瘤负荷>50%者。本组患者主要不良反应为肝功能损害、发热及胃肠道反应等,经相应对症处理可缓解。结论经肝动脉塞及插管持续化疗是治疗胃肠癌肝转移的安全有效方法,值得临床推广。

Clinical study of the the efficacy of TACE or TAI in treatment of liver metastasises in patients with gastric and colorectal cancer

Objective To investigate the efficacy of TACE or TAI in treatment of liver metastasises in patients with gastric and colorectal cancer. Methods 18 patients with liver metastasises coming from gastric or colorectal cancer after operation received a total of 58 times interventional therapy, by continuous intra-liver arterial infusion chemotherapy 40 times, other received TACE whith L-OHP 100mg and LP 10-30 ml were 18 times before continuous intra-liver arterial nfusion chemotherapy.Chemotharapy project:CF100mg iv drip d1-5,L-OHP135mg/m2,d1,by hypodermic drug case injection,5-Fu2500mg/m2,by portable transfusion pump continuous infusion 120 hours.Results The total effective rate(CR PR) was 66.67%.The effective rate of the patients with tumour load less than 50%was 70%.It was 37.5%in the cases with tumour load over 50%.The primary side-effect were liver function hurt,fever and digest tract reaction et al.By corresponded treatment those symptoms could improve.Conclusion TACE or TAI in treatment of liver metastasises in patients with gastric and colorectal cance were effective and safety.They were worth popularizing in clinic.