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A study of multimodal treatment strategy for malignant hepatic tumors using high-dose intrarterial chemotherapy combined with direct hemoperfusion under hepatic venous isolation.

肝静脉隔离下大剂量动脉化疗联合直接血液灌流治疗肝癌多模式治疗策略的研究

基本信息

批准号：
04670781
负责人：
GU Eisei
金额：
$ 1.34万
依托单位：
KOBE UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1992
资助国家：
日本
起止时间：
1992 至 1993
项目状态：
已结题

项目摘要

This study was undetaken to establish a multimodal treatment strategy for malignat hepatic tumors using high-dose intraarterial chemotherapy combined direct hemoperfusion under hepatic venous isolation(HVI・DHP). In the first year of the term of this project, we demonstrated experimentally that a combined use of angiotensin II with anticancer drugs under HVI・DHP further increased drug delivery to hepatic tumors. In addition, the hepatic extraction rates of major anticacer drugs including adriamycin, which had not been fully elucidated in the previous studies, were reevaluated with the aid of HVI・DHP, and were clarified during this investigation. Accordingly in the second year, we investigated the role of high-dose chemotherapy under HVI・DHP in the multimodal treatment for hepatic tumors. This clinical study clearly demonstrated that both response and survival benefit obtained by high-dose chemothrapy was further prolonged with additional low-dose intraarterial chemotherapy using an implantable catheter system. These results strongly indicate that high-dose induction teratment combined with low-dose maintenance treatment would provide significant therapeutic benefits for patients with advanced hepatic tumors in currently hopeless situations. As a future direction, we consider that further technical simplification of HVI・DHP is required to perform repeated high-dose treatment. In this regard, we have currently designed a 4-lumen・2-balloen catheter, which may promote the world-wide acceptance of this treatment.

本研究旨在建立大剂量动脉化疗联合肝静脉隔离下直接血液灌流（HVI·DHP）治疗肝癌的多模式治疗策略。在本项目的第一年，我们通过实验证明，在HVI·DHP下联合使用血管紧张素II与抗癌药物进一步增加了药物向肝肿瘤的递送。此外，主要抗癌药物包括阿霉素的肝提取率，这在以前的研究中没有得到充分的阐明，重新评估的帮助下，HVI·DHP，并在本次调查澄清。因此，在第二年，我们研究了HVI·DHP下的大剂量化疗在肝脏肿瘤多模式治疗中的作用。这项临床研究清楚地表明，使用植入式导管系统进行额外的低剂量动脉内化疗，可进一步延长高剂量化疗获得的缓解和生存获益。这些结果有力地表明，高剂量诱导治疗结合低剂量维持治疗将为目前无望的晚期肝肿瘤患者提供显着的治疗益处。作为未来的发展方向，我们认为需要进一步简化HVI·DHP的技术，以进行重复的高剂量治疗。在这方面，我们目前设计了一种4腔·2球囊导管，这可能会促进这种治疗在世界范围内的接受。