Combined modality therapy of hepatic metastasis
Combined modality therapy of hepatic metastasis
复制标题
肝转移瘤的综合治疗
作者：
M. Friedman;Michael Cassidy;Michael L. Levine;T. Phillips;S. Spivack;K. Resser
作为I-II期研究的一部分，22例肝转移腺癌患者接受快速分次全肝照射（300 rad分次，1350-2100 rad），同时肝内5-氟尿嘧啶（10-15 mg/kg/天）和肝内阿霉素（2.5-10 mg/m2/天）治疗。在完成治疗的21例患者中，19例患有结直肠癌，2例患有来源不明的转移性腺癌。通过测量肝脏大小、评价肝功能检查以及肝脏扫描或CAT扫描判断客观缓解。21例可评价患者中有10例应答，总应答率为47.6%。结直肠癌患者的有效率为55%（10/19）。此时，中位缓解持续时间为14+周，自治疗开始的中位生存期为15+周。血液学和胃肠道毒性可耐受。未记录肝毒性。该综合疗法是一种安全、有效的姑息治疗肝转移癌的方法。
Twenty‐two patients with adenocarcinoma metastatic to the liver were treated with rapid fractionation whole‐liver irradiation (1350–2100 rads in 300‐rad fractions) with simultaneous intrahepatic 5‐fluorouracil (10–15 mg/kg/day) and intrahepatic Adriamycin 2.5–10 mg/m2/day) as part of a Phase I‐II study. Of the 21 patients who completed therapy, 19 had colorectal carcinoma and 2 had metastatic adenocarcinoma of unknown origin. Objective response was judged by measurement of liver size, evaluation of liver function tests, and by liver scan or CAT scan of the liver. Ten of the 21 evaluable patients responded, yielding an overall response rate of 47.6%. The response rate in patients with colorectal carcinoma was 55% (10/19). At this time, median duration of response is 14+weeks and median survival from onset of therapy is 15+weeks. Hematologic and gastrointestinal toxicity were tolerable. No hepatic toxicity was documented. This combined modality therapy was found to be a safe, effective method for the palliation of liver metastasis.