经肝动脉热灌注化疗栓塞治疗肝转移癌

目的：评价经肝动脉热化疗栓塞治疗肝转移癌的临床效果。方法：63例肝转移癌患者随机分为两组，热化疗组30例，经动脉超选择性热化疗栓塞，将5一氟尿嘧啶、丝裂霉素及顺铂分别与生理盐水混合，用热疗机加热至65℃后经导管缓慢注入肝动脉，注射完成后用超液化碘油栓塞肿瘤供血动脉。常温组33例，经导管将与热化疗组相同化疗药常温灌注后用超液化碘油栓塞肿瘤供血动脉。术后观察体温、肝功及有无并发症出现。所有患者每间隔1月重复1次，最少完成3次治疗。每月复查CEA及肝脏CT，观察肿瘤内碘油沉积及病灶大小、数目及CEA变化并统计患者生存率。结果：热化疗组生存率：6月、12月、18月、24月分别为100％、93％、73％、60％，与常温组相比有显著性差异（P〈0．01）；治疗后热化疗组肿瘤数目及大小较常温组明显减少和缩小，有显著性差异（P〈0．01）；两组之间碘油沉积、体温、肝功能、并发症无显著差异（P〉0．05）。结论：经肝动脉热化疗栓塞治疗肝转移癌能显著提高疗效，延长患者生存期。

Hepatic arterial perfusion thermochemotherpy and embolism for hepatic metastasis tumor

Objective：To evaluate the therapeutic effects of thermochemotherpy by intervention embolism for hepatic metastasis tumor. Methods： Sixty three eases with hepatic metastasis tumor were randomly divided into two groups, one with 30 cases and the other with 33 cases administered with thermoehemotherpy and conventional chemotherapy respectively. The sodium chloride solution of 5 - FU, Mitomycin and diamminedichloro platinum were given through selected hepatic artery to the two groups at 65℃ and normal temperature respectively. And then the feeding artery of carcinoma was embolismed with Lipiodol. All the cases were administered at least three times at intervals of one month. CEA and liver CT were performed every month to observe the level of CEA and the size, number and the lipiodol deposition of tumor. The survival rates were analyzed every month. Results： The 6 - , 12 - , 18 - , and 24 - month survival rate of thermochemotherpy group was 100%, 93% ,73% and 60% respectively which was different from the other group significantly（ P 〈 0.01 ）. The size and the number of tumor was smaller and less in thermoehe- motherpy group than that of conventional chemotherapy group（ P 〈 0.01 ）. While the Lipiodol deposition, body temperature,hepatic function and complication in two groups were similar（P 〉 0.05 ）. Conclusion： Intervention thermoche- motherpy embolism for liver metastasis tumor could increase the therapeutic effect and prolong the survival term of patients.