消化道肿瘤肝转移介入治疗的临床疗效

目的　评价消化道肿瘤肝转移患者经肝动脉介入治疗的临床疗效及价值。方法　对92例消化道肿瘤肝转移患者经肝动脉介入治疗 316次。化疗药物选用EADM、PDD、MMC、CF、5 Fu联合方案 ,加超液化碘油单独或加明胶海绵栓塞。结果　近期疗效以CT检查结果作为评价标准 ,总有效率为 45 .7% ,平均生存期为 19.6个月。本组 0 .5 ,1,2 ,3,5年生存率分别为 95 .7%、73.8%、30 .9%、17.6 %和 9.9%。 9例肝内孤立性转移者疗效最好 ,平均生存期 31.2个月。综合治疗可提高疗效 ,全组无严重副作用或并发症。结论　经肝动脉介入治疗是治疗消化道肿瘤肝转移瘤的较好方法 ,其不仅能提高疗效 ,而且能改善患者的生活质量。

Infusion chemotherapy and chemoembolization of liver metastases from cancer of the alimentary tract

Objective To evaluate the efficacy of hepatic artery infusion chemotherapy and chemoembolization in the treatment of liver metastases from alimentary tract cancer.Methods A total of 92 patients with unresectable liver metastases from alimentary tract cancer was treated 316 times by hepatic artery infusion chemotherapy and chemoembolization. Of the 92 patients, only infusion chemotherapy was performed in 29 patients, and infusion chemotherapy and chemoembolization in 63 patients. Chemotherapy was carried out with a combination of epirubicin and/or cisplatin, mitomycin C , calcium folinate and 5 fluorouracil. Embolization was accomplished with lipiodol ultra fluid or lipiodol ultra fluid and gelatin sponge. Response rates were assessed by CT scanning. Results An overall response rate (CR PR) of the cases was 45.7%. The mean survival period of 92 patients was 19.6 months. The 0.5 , 1 , 2 , 3 and 5 year survival rate was 95.7%, 73.8%, 30.9%, 17.6% and 9.9%, respectively. Best therapeutic results were obtained in 9 cases with single metastastic focus in the liver, with a mean survival period of 31.2 months. There was no severe side effect or complication.Conclusion Treatment by transcatheter hepatic artery infusion chemotherapy and chemoembolization is beneficial to patients with metastastic cancer of the liver.