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

我们已经建立了一个新的大剂量动脉内化疗系统，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，同时最大限度地减少全身毒性。这个项目的目的是发展多模式治疗策略的恶性腹部肿瘤在肝脏，胰腺和骨盆。对于肝脏肿瘤，我们从经皮离体肝灌注（PIHP）的临床试验中证实，在同一患者上重复治疗比单次治疗可进一步扩大该治疗的治疗指标。在晚期肝细胞癌（HCC-stageIVA）患者中，结果显示完全和部分缓解率达到63%，5年生存率提高到30%。此外，基于我们的研究结果，我们启动了PIHP对HCC切除术后复发高风险患者的预防作用的随机研究。现在，我们的数据显示，PIHP切除后显著降低复发率，提高无瘤生存。此外，对于无法切除肿瘤的患者，我们也进行了HCC合并PIHP的复位手术。复位术联合PIHP可提高晚期肝癌的切除率和生存率。同时，我们也使用PIHP治疗了8例结直肠癌肝转移患者。我们引入了一种新的治疗方案，将反复PIHP作为这些患者的诱导，并将间歇性输注作为这些患者的维持治疗，并显示了PIHP对疾病的疗效。针对多发肝转移多发的胰腺癌，我们开展了PIHP作为肝转移预防性治疗的新试验。另一方面，开展了肾下腔静脉分离炭血灌流联合盆腔化疗灌流治疗晚期子宫癌的临床试验。我们设计了一种盆腔化疗灌流作为新辅助化疗的方案来降低晚期子宫癌的分期，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联合外周血干细胞移植进行超高剂量化疗。基于这些结果，我们得出结论，我们的方法为腹部恶性肿瘤患者提供了有效的治疗选择。少

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