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目的 探讨 5 氟尿嘧啶 (5 Fu) /甲酰四氢叶酸钙 (CF)经肝动脉持续性灌注治疗结直肠癌肝转移的临床疗效。方法 6 2例无外科手术指征的结直肠癌肝转移患者 ,其原发病灶均已作根除术 ,依据肝动脉内化疗方式不同分为 2组 :A组 32例 ,采取经皮肝动脉内植入药盒 ,术后经药盒每个月连续 5d持续灌注 5 Fu/CF及地塞米松 ;B组 30例 ,采取每个月 1次肝动脉插管大剂量灌注 5 Fu/CF。结果 A、B组有效率 (完全缓解 +部分缓解 )分别为 5 0 0 %和 2 3 3%(P <0 0 5 )。A组 1年、2年生存率分别为 6 5 6 %、39 3%;B组分别为 36 7%、11 5 %(P <0 0 5 )。A组生存质量明显改善 ,肝、胆、胃十二指肠毒性均较B组低。结论 经药盒肝动脉持续性灌注 5 Fu/CF并配合地塞米松治疗结直肠癌肝转移可明显改善患者生存质量 ,提高生存率。
Objective To investigate the clinical efficacy of 5-fluorouracil (5 Fu)/calcium folinate (CF) in the treatment of colorectal liver metastasis by continuous hepatic artery perfusion. Methods Sixty-two patients with colorectal liver metastases without surgical indications had their primary lesions eradicated. They were divided into 2 groups according to the different intrahepatic arterial chemotherapy regimens: 32 patients in group A received transcutaneous hepatic arterial embolization. After implantation of the kit, 5 Fu/CF and dexamethasone were continuously infused through the kit for 5 days each month; 30 patients in group B received 5 Fu/CF perfusion of hepatic artery catheter once a month. Results The effective rates of A and B groups (complete remission and partial remission) were 500% and 233% respectively (P < 0 05). The one-year and two-year survival rates in group A were 665 and 39. 3%, respectively, and those in group B were 36.7% and 115%, respectively (P < 0 05). The quality of life in group A was significantly improved, and liver, gallbladder and gastroduodenal toxicity were lower than in group B. Conclusion Continuous infusion of 5 Fu/CF through the hepatic artery and dexamethasone in the treatment of colorectal liver metastases can significantly improve the quality of life and improve survival.