经皮药盒植入动脉热灌注化疗的临床应用

目的 :探讨介入放射方法经皮股动脉植入药盒治疗中晚期肿瘤的可行性和疗效。材料与方法 :40例中晚期恶性肿瘤患者采取经皮股动脉植入药盒 ,行动脉热灌注化疗。其中 ,肝癌 2 7例 ,肾癌 3例 ,盆腔肿瘤 6例 ,肺癌 4例。依据肿瘤的供血情况 ,在DSA减影和透视监视下 ,进行药盒植入。药盒导管端植入靶动脉内 ,药盒体埋置在穿刺点下方皮下 ,按不同肿瘤设计不同化疗方案 ,通过皮下药盒注射药物 ,每 1疗程间隔 2 1～ 2 8d ,连续 3～ 4个疗程 ,术后 2周 1次用肝素盐水冲洗药盒 ,以防止导管阻塞。结果 :全部 40例药盒植入 1次成功 ,患者生存质量明显改善 ,本组病人的近期有效率为 75 % ,超过 1年累计生存率为 5 2 5 % (2 1 /4 0 )。随访病例最长者达 2 8个月 ,无严重并发症发生 ,植入药盒侧股动脉血管造影和彩色血流分析无异常改变。结论 :经皮药盒植入动脉热灌注化疗 ,安全可行 ,操作简便 ,且经动脉途径序贯化疗 ,保留了动脉内 1次冲击化疗的优势 ,使热化疗与药盒植入有机结合 ,利于维持靶区高药物浓度和化疗药物配伍设计 ,明显提高疗效 ,适宜于中晚期肿瘤的治疗

Clinical Application of Chemotherapy with Warmed Infusion via Subcutaneous Drug Reservoir

Objective:To discuss the possibility and curative effect of chemotherapy with warmed infusion via subcutaneous drug reservoir,that implanted in femoral artery with interventional method to treat mid and late stage tumors.Methods:40 cases of mid and late stage tumor were undertaken with this method.Among them there were 27 cases of liver carcionma,3of kidney tumors,4lung cancer and 6 of pelvic cavity carcinoma.The drug reservoir duct was implanted in the target artery according to the tumor blood supply and reservoir was at point of punctrue subcutaneously under DSA and flurometry.The drug were injected through drug reservoir that varied program was taken according to different type of carcinoma.The interval between each course of treatment were 21～28 d with continuouw 3～4 courses.The reservoir was washed twice a week heparion to prevent the blockage of the duct.Results:All reservoirs were implanted successfully at first time and the survival qualities of patients were improved without severe comlpications.The reccnt effective rate was 75% and survival rate of over 1 year waw 52.5% and the longcst follow-up was 28 months.There were no abnomal changer at implanted femoral artery side under angiography and Doppler lutrasonic detection.Conclusions:This method might be safe,available and simple to perform via artery sequential chemotherapy.It could remain the impulsive advantage.The combiation of warmed chemotherapy and drug reservoir could be profit to maintain the gigh dose of drug at target area and drug design.It should be suitable to mid and late stage of carcinoma patients that could improve the curative effects.