选择性动脉灌注加栓塞化疗治疗直肠癌肝转移的研究

目的：探讨直肠癌肝转移的有效治疗方法.方法：对99例直肠癌肝转移患者进行腹腔动脉灌注加肝动脉栓塞化疗（观察组）与静脉化疗（对照组）的随机对照研究.观察组52例,第一次灌注后4周重复一次,以后每间隔2～3个月进行一次灌注;对照组47例,采用静脉给药,三周重复1次.结果：治疗3个月后,观察组原有上腹疼痛减轻或消失者占70.6%,肝内肿块缩小占55.8%,对照组肝区疼痛减轻或消失者占20%,肝内肿块缩小占10.6%,两组病例1、2、3年生存率分别为80.8%、46.2%、25.0%和61.7%、19.1%、4.3%.结论：对于不能手术的结直肠癌肝转移,腹腔动脉灌注加肝动脉栓塞化疗在改善临床症状及延长生存期上较静脉化疗更有效,是一个较好的姑息性治疗方法.

A Study on Selective Arterial Infusion and Embolization Chemotherapy in Patients with Liver Metastases from Colorectal Cancer

Objective:To suggest a more effective method for treatment of rectal cancer metastasis to the liver.Methods:Ninety-nine cases with liver metastases from colorectal cancer were randomly divided into groups that received local celiac artery infusion with hepatic artery embolization chemotherapy(CAIHAEC)or venous chemotherapy(VC).Fifty-two cases were in the CAIHAEC group.The second CAIHAEC treatment was administered 4 weeks after the first treatment.After that the CAIHAEC treatments were performed every 2 or 3 months.Forty-seven cases were in the VC group.Their procedures were repeated every 3 weeks.Results:After 3 months,the percentage of patients in the CAIHAEC group whose upper abdominal pain was relieved or disappeared was 70.6%,and in 55.8% of these patients the liver masses became smaller.After 3 months,the percentage of patients in the VC group who reported that the pain in the hepatic area was relieved or disappeared was 20%,but only 10.6% of these patients had liver masses that become smaller.One-,2-,and 3-year survival rates for the CAIHAEC group were 80.8%,46.2%,and 25.0%,respectively;1-,2-,and 3-year survival rates for the VC group were 61.7%,19.1%,and 4.3%,respectively(P<0.01).Conclusion:To treat colorectal liver metastases,CAIHAEC is more reliable for relieving clinical symptoms and prolonging survival when compared with VC.It is a better palliative treatment for unresectable colorectal liver metastases.