肝转移瘤动静脉双途径联合化疗的临床研究
Clinical Research on the Double Ways Combination Chemotherapy of Artery and Vein Treating the Liver Metastatic Tumours
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摘要: 目的 观察动静脉双途径联合化疗治疗肝转移瘤的临床疗效及不良反应。方法 根据原发肿瘤病理类型、化疗药物作用特点及代谢特征, 将每一化疗方案中细胞周期非特异性药物 (环磷酰胺、异环磷酰胺除外 )经肝动脉灌注或栓塞, 细胞周期特异性药物经外周静脉给药。静脉给药于动脉给药后第 3天开始, 4周为 1周期, 至少进行 3周期。每周期治疗前重点复查肝脏CT及相关肿瘤标志物, 随访时间从治疗结束至死亡。结果 总有效率与平均生存期分别为肺鳞癌 6 0 .0 %、13.2月, 肺腺癌 5 5 .5 %、10 .8月, 肺小细胞癌 75 .0 %、31.4月, 胃癌 5 3.3%、17.6月, 胆囊癌 33.3%、10 .9月, 大肠癌 6 3.3%、18.8月, 乳腺癌 6 6 .6 %、2 1.7月, 卵巢癌 6 6 .6 %、2 3.4月 ;5 6例肝转移瘤治疗前相关肿瘤标志物值均高于正常值, 治疗结束后均显著降低, P <0 .0 1。该治疗方法不良反应与单一静脉化疗基本相同。结论 动静脉双途径联合化疗是众多肝转移瘤治疗方法中较为理想的一种可行手段。Abstract: Objective To observe the clinical effect and adverse reaction of the liver metastatic tumors treated by the combination chemotherapy of the two ways of artery and vein. Methods In according to the pathologic types of the primary tumors,the distinction of action and metabolism of chemicals,the cell cycle nonspecific agents(CCNSA) to be infused or add to embolism by the liver artery (except CTX and IFO),the cell cycle specific agents (CCSA) to be injected by peripheral vein,from each chemotherapy scheme. Vei...
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