CHEMOEMBOLIZATION AFTER CHEMOTHERAPY & RADIATION TREATMENT IN HEPATIC CANCER

对于涉及肝脏和/或胆管的癌症，有许多潜在的“标准”治疗方法。一种可能的方法，手术切除，往往是不可能的。另一种治疗方法是药物治疗（化疗）。然而，目前可用的静脉注射（通过静脉给予）药物治疗的价值有限（只有约20%的患者显示肿瘤缩小）。第三种方法是单独进行放射治疗。与单独化疗一样，每天一次的单独放射治疗效果有限。我们正试图开发一种更有效的治疗这些癌症的方法。我们正在研究用一种叫做丝裂霉素C的标准抗癌药物进行化疗栓塞的有效性和副作用。化疗栓塞包括将丝裂霉素C注射到向肝脏供血的动脉（肝动脉）中，然后立即注射小颗粒来阻止一些血液流动。在给予化疗栓塞之前，肝动脉在给予肝脏放疗的同时给予另外两种标准化疗药物（氟脱氧尿嘧啶和亚叶酸钙），疗程为两周。这些药物可自行产生抗肿瘤作用，并可提高放射治疗的有效性。有相当多的化疗栓塞的经验。肝动脉氟脱氧尿嘧啶和亚叶酸素治疗肝放疗后的这种治疗尚未进行试验。因为我们正在努力确定可以给多少丝裂霉素C，一些病人会比其他人接受更多的药物治疗。在5年的时间里，接受这项研究方案治疗的患者数量将约为60-70人。我们将研究的结果包括毒性（即副作用的严重程度）、肿瘤大小的变化和生存率。

There are a number of potential "standard" treatments for cancer involving the liver and/or bile ducts. One possible approach, surgical removal, is frequently not to be possible. Another therapy is drug treatment (chemotherapy). However, currently available intravenous (given by vein) drug treatment has had limited value (only about 20% of patients show tumor shrinkage). A third approach is radiation therapy alone. As with chemotherapy alone, radiation therapy alone given once a day has had limited success. We are attempting to develop a more effective therapy for the treatment of these cancers. We are investigating the effectiveness and side effects of chemoembolization with a standard anticancer medication called mitomycin C. Chemoembolization involves injecting mitomycin C into an artery which supplies some of the blood to the liver (the hepatic artery), and immediately afterward, injecting small particles to stop some of the blood flow. Before the chemoembolization is given, a two week course of two other standard chemotherapy drugs (fluorodeoxyuridine and leucovorin) will be given by the hepatic artery at the same time that radiation is given to the liver. These other drugs can produce antitumor effects by themselves and can improve the effectiveness of the radiation. There is a considerable amount of experience with chemoembolization. Such treatment after liver radiation with hepatic arterial fluorodeoxyuridine and leucovorin has not been tested. Because we are trying to determine how much mitomycin C can be given, some patients will receive more of the medication than other people. The number of patients to be treated on this research protocol will be approximately 60-70 over a 5 year period of time. The outcomes we will study include toxicity (i.e., the severity of side effects), change in tumor size, and survival.