大肠癌肝转移治疗方法的比较

目的：比较大肠癌肝转移不同治疗方法的疗效，探讨治疗原则。方法：对89例大肠癌肝转移患者进行回顾性分析。将患者按照不同的治疗方法分析4组，根据随访资料和统计学分析，比较各组的治疗效果。结果：根治性手术切除组的1、3年生存率分别为80％和30％，最长者生存62个月。静脉化疗组中位生存期为7个月，皮下植入泵肝动化疗组和经皮穿刺肝动脉导管化疗组的治疗有效率可达到31．0％和46．5％，但长期疗效受肿瘤血供等因素影响，患者中位生存期为15个月，经Cox逐步回归多因素分析，肝动脉化疗与静脉化疗在生存期上差异无显著性意义（P＝0．13）结论：对于大肠癌肝转移患者，根治手术切除是效果最好的治疗方法，肝动脉化疗能否延长患者生存期仍需进一步探讨。

Comparison of different therapies for colorectal cancer liver metastases

Objectives　To compare the effect of different treatments of colorectal liver metastases and to discuss the principles for the treatments.　Methods　Eighty-nine patients with colorectal liver metastases were analyzed. The patients were divided into 4 groups according to different treatments, and the effects of the treatments were followed up and analyzed statistically.　Results　Ten patients had undergone curative resection with a 1-,3-year survival rate of 80% and 30% respectively. The longest survival period was 62 months. Twenty patients accepted introvenous chemotherapy, with a median survival period of 7 months only. Thirteen patients underwent hepatic artery infusion with implanted pump and 43 patients underwent transcatheter arterial chemoembolization. The response rate of the two groups was 31% and 46.5%; their median survival period was 15 months. Intrahepatic chemotherapy could gain a higher response than systemic therapy, but there was no significant difference in survival as shown by multivariate analysis.　Conclusions　Curative resection is the best therapy for colorectal liver metastases. Whether intrahepatic chemotherapy prolongs patients′ survival should be further studied.