胃肠道间质瘤肝转移介入治疗疗效分析

Transcatheter hepatic arterial chemoembolization in treatment of GIST with metastatic liver cancer

目的观察经肝动脉化疗栓塞(TACE)治疗胃肠道间质瘤(GIST)肝转移的临床疗效。方法对4例胃肠道间质瘤肝转移患者共19个病灶,病灶直径2～5cm,经肝动脉灌注FuDR、CDDP、EPI-ADM,用超液化碘油和明胶海绵作动脉栓塞,每例平均2～4次。结果DSA显示GIST肝转移灶动脉血供丰富,染色明显,经TACE治疗后,肝转移灶未见缩小,碘油较快被清除,4例患者无CR或PR,2例改服伊马替尼有效。结论有限的病例显示TACE治疗胃肠道间质瘤肝转移未见明显疗效。

Objective To observe the clinical curative effect of transcatheter hepatic arterial chemoembolization （TACE） in treatment of gastrointestinal stromal tumors （GIST） with metastatic liver cancer. Methods Four GIST patients with 19 lesions of liver metastasis were treated with 2 ～ 4 times of TACE. The diameters of the metastatic tumor were from 2 ～ 5 cm. FuDR, CDDP, EPI-ADM, together with lipiodol ultrafluid and gelatin sponge to from a mirture was prepared for arterial embolization. Results DSA showed abundant tumor vasculature and tumor stain on hepatoarterial angiography. The size of tumor showed no decrease after TACE and lipiodol was cleared away in a short period. No patient achieved CR or PR until two of them received imatinib. Conclusions TACE is not effective in treating hepatic metastasis from GIST shown in limited cases. （J Intervent Radiol, 2006, 15： 283-285）