肝动脉灌注5—FuDR与全身化疗治疗不能手术切除大肠癌来源的肝转移瘤

目的 观察肝动脉灌注5-氟尿嘧啶脱氧核苷(5-FuDR)联合全身化疗(CF+5-Fu)治疗不能手术切除大肠癌来源的肝转移瘤患者的疗效和毒性。方法 49例患者行经皮左锁骨下动脉穿刺导管药盒系统植入术,术后动脉内灌注5-FuDR 750mg/d×5;结合全身化疗CF+5-Fu(CF 200mg/d×5,5-Fu 0.5 g/d×5)。所有患者至少接受2个疗程以上的化疗。结果 CR 4例,PR 18例,NC 17例,PD 10例,有效率为44.0％;6个月、1年、2年的生存率达91.8％、72.0％和34.7％。患者的主要毒性反应为色素沉着、腹泻、黏膜炎、恶心、呕吐和中性粒细胞减少等,毒性均为Ⅰ～Ⅱ度,6例患者出现与导管有关的并发症(2例脓肿,2例出血,1例气胸和1例硬化性肝炎)。结论 肝动脉灌注5-FuDR结合全身化疗治疗晚期肝转移癌疗效好,毒副反应轻,值得临床推广应用。

Intra-arterial 5-FuDR and intravenous folinic acid plus 5-Fluorouracil in the treatment of unresectable colorectal cancer metastasized to liver

Objective To evaluate the anti-tumor efficacy and safety of intraarterial 5-FuDR infusion and intravenous administration of folinic acid plus 5-fluorouracil in the treatment of colorectal cancer metastasized to liver. Methods Percutaneous puncture of subclavian artery and port-catheter system implantation were carried out for treatment of 49 patients with intraarterial 5-FuDR(750 mg/d x 5) infusion and conventional systemic chemotherapy (CF 200 mg/d x 5,5-Fu 0. 5g/d x 5). All patients received at least two cycles of chemotherapy. Results There were four CR, eighteen PR, seventeen NC and ten PD in this series with a total response rate of 44.0 % . The 0.5-, 1-,2-year survival rates were 91.8% ,72.0% ,34.7% ,respectively.The main side-effects included pigmentation, diarrhea,mucositis,nausea, vomiting, and neutropenia, which were either I or II degree in severity. Six patients experienced catheter-related complications, including 2 abscesses, 2 haematomas, 1 pheumothorax, and 1 biliary sclerosis. Conclusion This regimen has higher responses rate and few systemic toxicities.