Regional chemotherapy of colorectal cancer metastatic to the liver
Regional chemotherapy of colorectal cancer metastatic to the liver
复制标题
结直肠癌肝转移的区域化疗
作者：
J. Niederhuber;W. Ensminger;J. Gyves;James H. Thrall;S. Walker;Edith Cozzi
93 名经活检证实结直肠癌肝转移的患者接受了肝动脉输注 5-氟脱氧尿苷 (FUDR) 治疗。其中男性 52 名，女性 41 名（中位年龄 60 岁）。 42 名患者 (45%) 之前的全身化疗失败。如果肝动脉解剖学规定，则通过手术放置导管并使用多个导管，以获得整个肝脏的灌注。该药物通过完全植入的 INFUSAID 400 型泵输送，患者接受周期治疗，包括 2 周 0.3 mg/kg/d FUDR 与 2 周生理盐水交替。肝外肿瘤患者或肝肿瘤对 FUDR 无效的患者除 FUDR 外，还每 6 至 8 周动脉注射 15 mg/m2 丝裂霉素 C，每次 30 分钟。 93 名可评估患者中有 50 名出现局限于肝脏的转移性肿瘤。在这 50 名患者中，83% 的患者表现出肿瘤大小显着减小，中位缓解持续时间为 13 个月，诊断肝转移后中位生存期为 25 个月。这 50 名患者中有 24 人还活着。 43 名患者除肝脏肿瘤外还出现肝外转移，74% 的患者有缓解，中位持续时间为 6 个月，中位生存期为 14 个月。在患有肝外肿瘤的患者中，只有六名患者还活着。 93名患者中没有一人仅死于未控制的肝脏肿瘤，只有9名患者死于未控制的肝转移和播散性肝外肿瘤。两组的生存时间取决于肝外肿瘤不受控制的进展。对于仅累及肝脏的转移性结直肠癌患者，单独使用肝动脉 FUDR 并添加丝裂霉素 C 可以很好地控制肝脏肿瘤。在这项不受控制的研究中，生存期似乎延长了。癌症 53：1336-1343，1984 年。
Ninety‐three patients with biopsy‐proven colorectal cancer metastatic to the liver were treated with hepatic arterial infusion of 5‐fluorodeoxyuridine (FUDR). There were 52 men and 41 women (median age, 60 years). Forty‐two patients (45%) had failed prior systemic chemotherapy. Catheters were operatively placed and multiple catheters were used if dictated by hepatic arterial anatomy in order to obtain perfusion of the entire liver. The drug was delivered by a totally implanted INFUSAID model 400 pump and patients received cyclic therapy consisting of 2 weeks of 0.3 mg/kg/d FUDR alternating with 2 weeks of saline. Patients with extrahepatic tumor or patients whose hepatic tumor failed to respond to FUDR were given a 30 minute intraarterial infusion of mitomycin C, 15 mg/m2, every 6 to 8 weeks in addition to FUDR. Fifty of the 93 evaluable patients presented with metastatic tumor confined to the liver. Of these 50 patients, 83% demonstrated a significant reduction in tumor size with a median duration of response of 13 months and a median survival of 25 months from diagnosis of liver metastases. Twenty‐four of these 50 patients remain alive. Forty‐three patients presented with extrahepatic metastases in addition to their liver tumor, and 74% had a response with a median duration of 6 months and a median survival of 14 months. Only six patients of those presenting with extrahepatic tumor remain alive. None of the 93 patients died solely of uncontrolled liver tumor, and only 9 died as a result of uncontrolled liver metastases and disseminated extrahepatic tumor. The duration of survival for both groups was determined by the uncontrolled progression of extrahepatic tumor. In patients with metastatic colorectal cancer involving only the liver, hepatic arterial FUDR alone and with the addition of mitomycin C provided excellent control of hepatic tumor. Survival appeared to be prolonged in this uncontrolled study. Cancer 53:1336‐1343, 1984.
使用植入式输液泵长期肝动脉输注 5-氟脱氧尿苷治疗肝转移。
DOI：
10.1200/jco.1983.1.5.337
发表时间：
1983
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
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作者：
Weiss,GR;Garnick,MB;Osteen,RT;SteeleJr,GD;Wilson,RE;Schade,D;Kaplan,WD;Boxt,LM;Kandarpa,K;Mayer,RJ
通讯作者：
Mayer,RJ