Percutaneous chemoperfusion with complete venous isolation and charcoal hemoperfusion for treatment of abdominal cancer

完全静脉隔离经皮化疗和炭血灌流治疗腹部肿瘤

• 批准号: 06454386
• 负责人: GU Eisei
• 金额: $ 4.16万
• 依托单位: KOBE UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-06454386/
• 关键词: Percutaneous isolated organ chemoperfusion; Venous isolation and charcoal hemoperfusion; High-dose chemotherapy; 肝細胞癌; 骨盤腫瘍; 子宮癌; 肝潅流化学療法; 肝癌

We developed a new treatment system for high-dose intraarterial chemotherapy with complete venous isolation and charcoal hemoperfusion in an attempt to maximize tumor drug delivery and, at the same time, to minimize systemic toxicity. This study was designed to develop multimodal treatment strategies for malignant abdominal tumors in the liver, the pancreas, and the pelvis. In the first year, we established a single catheter technique of percutaneous isolated liver chemoperfusion (PILP) and initiated a clinical trial of repeated treatment on the same patient. Our findings clearly showed that repeated treatments further expand the therapeutic index of this treatment for malignant liver tumors. On the other hand, we initiated the phase II clinical trial of pelvic chemoperfusion with infrarenal inferior vena caval isolation and charcoal hemoperfusion (IVCI・CHP) for advanced uterine cancer. In addition, we completed an experimental study on portal venous isolation and charcoal hemoperfusio … More n for pancreatic cancer. In the second vear, we introduced a new treatment protocol combining repeated PILP as the inductive therapy with low-dose intermittent infusions as the maintenance therapy for patients with advanced hepatoccellular carcinoma. For IVCL・CHP,a protocol of neoadjuvant chemotherapy was designed to achieve down-staging of advanced uterine cancer. Three patients with uterine cancer have been treated with this protocol. One patient had a complete tumor necrosis, as proved microscopically after operation, and two had a partial response. Thus we confirmed the efficacy of this treatment for pelvic tumors. In the third year, we attempted to treat pancreatic tumor with this treatment.However, we could not have patients with indication for the treatment. In patients with advanced hepatocellular carcinoma, we assessed the long-term results of the multimodal treatment with use of PILP.The results indicated that 5-year survival rate reached 40% and that 4 of 30 patients had a long-term tumor-free survival in a range of 2 to 4 years. We have also treated 15 patients with colorectal hepatic metastases, and have shown the efficacy of PILP for the disease. Based on these results, we concluded that our method offers an effective therapeutic option for patients with malignant abdominal tumors. Less

我们开发了一种新的治疗系统，用于大剂量动脉化疗，并采用完全静脉隔离和活性炭血液灌流，以最大限度地提高肿瘤药物输送，同时最大限度地减少全身毒性。本研究旨在为肝脏、胰腺和盆腔的腹部恶性肿瘤制定多模式治疗策略。在第一年，我们建立了经皮隔离肝脏化学灌流（PILP）的单导管技术，并开始了对同一患者重复治疗的临床试验。我们的研究结果清楚地表明，重复治疗进一步扩大了这种治疗恶性肝脏肿瘤的治疗指数。另一方面，我们启动了盆腔化疗灌注联合肾下下腔静脉隔离和活性炭血液灌流（IVCI·CHP）治疗晚期子宫癌的II期临床试验。此外，我们还完成了门静脉电隔离和活性炭血液灌流的实验研究， ...更多信息 n胰腺癌。第二部分介绍了一种新的治疗方案，将反复PILP作为诱导治疗，小剂量间歇输注作为维持治疗，用于晚期肝癌患者。对于IVCL·CHP，设计了新辅助化疗方案，以实现晚期子宫癌的分期下调。三名子宫癌患者已接受该方案治疗。术后经显微镜证实，1例肿瘤完全坏死，2例部分缓解。因此，我们证实了这种治疗盆腔肿瘤的疗效。在第三年，我们尝试用这种疗法治疗胰腺肿瘤，但是我们没有病人有这种疗法的适应症。我们对晚期肝癌患者采用PILP多模式治疗的长期结果进行了评估，结果表明，5年生存率达到40%，30例患者中有4例长期无瘤生存2 ~ 4年。我们还治疗了15例结直肠肝转移患者，并显示了PILP对该疾病的疗效。基于这些结果，我们得出结论，我们的方法为恶性腹部肿瘤患者提供了一种有效的治疗选择。少

项目成果

Y.Ku: "Extracorporeal carbon chemofiltration under hepatic venous isolation for high-dose intraarterial chemotherapy of the liver." Surgery. 116. 941 (1994)

Y.Ku：“肝静脉隔离下的体外碳化学过滤，用于肝脏的高剂量动脉内化疗。”

Y. Ku.: "Direct hemoperfusion under infrahepatic inferior vena caval isolation for the intraarterial chemotherapy of pelyic tumors." Surgery Today. 24. 1031-1033 (1994)

Y. Ku.：“肝下下腔静脉隔离下的直接血液灌流用于盆腔肿瘤的动脉内化疗。”

Y. Ku.: "Percutaneous technique of hepatic venous isolation and charcoal hemoperfusion with a dual-ballon vena cava catheter." Surgery. 119. 360 (1996)

Y. Ku.：“使用双气囊腔静脉导管进行肝静脉隔离和木炭血液灌流的经皮技术。”

Y.Ku: "Clinical pilot study on high-dose intraarterial chemothepapy using direct hemoperfusion under hcpatic vanous isolation in patients with advanced hepatocellubr" SURGERY. 117(in press). (1995)

Y.Ku：“在肝静脉隔离下使用直接血液灌流对晚期肝细胞癌患者进行高剂量动脉内化疗的临床试验研究”。

Y.Ku: "Percutaneous technique of hepatic venous isolation and charcoal hemoperfusion with a dual-balloon vena cava catheter." Surgery. 119. 360 (1996)

Y.Ku：“使用双气囊腔静脉导管进行肝静脉隔离和木炭血液灌流的经皮技术。”