Induction of long-term remission in advanced malignant abdominal tumors with percutaneous isolated organ chemoperfusion

经皮离体器官化疗诱导晚期腹部恶性肿瘤长期缓解

• 批准号: 09470267
• 负责人: GU Eisei
• 金额: $ 5.76万
• 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: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09470267/
• 关键词: Percutaneous isolated organ chemoperfusion; Venous isolation and charcoal hemoperfusion; High-dose chemotherapy; 経皮的肝灌流; adriamycin; 大腸癌肝転移; cisplatin; 肝細胞癌

We have already established a new 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. The purpose of this project was to develop multimodal treatment strategies for malignant abdominal tumors in the liver, the pancreas, and the pelvis. As for the liver tumors, from the clinical trials using percutaneous isolated hepatic perfusion (PIHP), we have confirmed that repeated treatments on the same patient further expand the therapeutic index of this treatment compared with single treatment. In patients with advanced hepatocellular carcinoma (HCC-stageIVA), the results indicated that complete plus partial response rates reached 63% and that 5-year survival rate increased to 30%. Moreover, based on our findings, we initiated randomized study of the preventive utility of PIHP for the patients with high risks of recurrence after resection of HCC … More . Now, our data showed that PIHP after resection remarkably reduced the recurrence rate and improved the tumor free survival. In addition, we have performed reduction surgery of HCC combining with PIHP for the patients who had unresectable tumors until now. The reduction surgery combining PIHP has resulted in increasing resection rate and survival rate of advanced HCC. While, we have also treated 8 patients with colorectal hepatic metastases using PIHP. We have introduced a new treatment protocol combining repeated PIHP as the inductive for these patients and have intermittent infusions as the maintenance therapy for these patients and have shown the efficacy of PIHP for the disease. Relating to the pancreatic cancer, in which multiple liver metastases were common, we have initiated a new trial of PIHP as the prophylactic treatment against liver metastases. On the other hand, we have initiated clinical trial of pelvic chemoperfusion with infrarenal inferior vena caval isolation and charcoal hemoperfusion (IVCI-CHP) for advanced uterine cancer. A protocol with pelvic chemoperfusion as a neoadjuvant chemotherapy was designed to achieve down-staging of advanced uterine cancer and those results confirmed us the effectiveness of this treatment for pelvic tumors. Recently we have also tried PIHP with peripheral blood stem cell transplantation for the purpose of super high dose chemotherapy. Based on these results, we concluded that our methods offers an effective therapeutic option for patients with malignant abdominal tumors. Less

我们已经建立了一个新的系统，高剂量动脉化疗与完全静脉隔离和木炭血液灌流，试图最大限度地提高肿瘤药物输送，并在同一时间，以尽量减少全身毒性。该项目的目的是为肝脏、胰腺和骨盆的恶性腹部肿瘤制定多模式治疗策略。对于肝脏肿瘤，从使用经皮隔离肝灌注（PIHP）的临床试验中，我们已经证实，与单次治疗相比，对同一患者进行重复治疗进一步扩大了该治疗的治疗指数。在晚期肝细胞癌（HCC-stageIVA）患者中，结果表明完全加部分缓解率达到63%，5年生存率提高到30%。此外，基于我们的研究结果，我们开始了一项随机研究，探讨PIHP对肝癌切除术后高复发风险患者的预防作用 ...更多信息 .现在，我们的数据表明，切除后PIHP显着降低复发率，提高无瘤生存率。此外，我们还对至今不能切除的肝癌患者进行了肝癌减容术联合PIHP。减容术联合PIHP可提高晚期肝癌的切除率和生存率。同时，我们也用PIHP治疗了8例结直肠肝转移患者。我们引入了一种新的治疗方案，将重复PIHP作为这些患者的诱导治疗，并将间歇性输液作为这些患者的维持治疗，并已显示PIHP对该疾病的疗效。关于胰腺癌，其中多发性肝转移是常见的，我们已经开始了一项新的试验PIHP作为预防性治疗肝转移。另一方面，我们已经开始了肾下下腔静脉隔离和活性炭血液灌流（IVCI-CHP）盆腔化疗灌注治疗晚期子宫癌的临床试验。我们设计了一种将盆腔化疗灌注作为新辅助化疗的方案，以实现晚期子宫癌的分期下调，这些结果证实了这种治疗盆腔肿瘤的有效性。最近，我们也尝试了PIHP与外周血干细胞移植的超高剂量化疗的目的。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

具英成: "StageIV肝細胞癌に対する経皮的肝潅流化学療法(PIHP)のQOLと遠隔成績"日本消化器外科学会雑誌. 32. 1075-1079 (1999)

Eisei Gu：“IV 期肝细胞癌经皮肝灌注化疗 (PIHP) 的生活质量和远程结果”日本胃肠外科杂志 32. 1075-1079 (1999)。

Y. Ku: "Induction of long-term remission in advanced hepatocellular carcinoma with percutaneous isolated liver chemoperfusion" Annals of Surgery. (in press). (1998)

Y. Ku：“经皮离体肝化疗诱导晚期肝细胞癌长期缓解”《外科年鉴》。

Y. Ku: "Induction of long-term remission in advanced hepatocellular carcinoma with percutaneous isolated liver chemoperfusion"Annals of Surgery. 227. 519-526 (1998)

Y. Ku：“经皮离体肝化疗诱导晚期肝细胞癌长期缓解”《外科年鉴》。

M. Tomonaga: "Pharmacologic evaluation of portal venous isolation and characoal hemoperfusion for high-dose intraarterial chemothoerapy of the pancreas" British Journal of Surgery. 84. 1072-1076 (1997)

M. Tomonaga：“胰腺高剂量动脉内化疗的门静脉隔离和活性炭血液灌流的药理学评价”英国外科杂志。

M. Tominaga: "Pharmacologic evaluation of portal venous isolation and charcoal hemoperfusion for high-dose intraarterial chemotherapy of the pan"British Journal of Surgery. 84. 1072-1076 (1997)

M. Tominaga：“门静脉隔离和木炭血液灌流对大剂量动脉内化疗的药理学评价”英国外科杂志。