经肝动脉化疗栓塞术联合激光热疗治疗大鼠肝转移癌

Combination of Chemoembolizauion and Laser-induced Thermotherapy in the Treatment of Liver Metastasis in Rats

目的:评价经肝动脉化疗栓塞术(TACE)联合激光热疗(LITT)治疗大鼠肝转移癌的疗效。方法:30只雄性WAG大鼠肝包膜下注入CC531结直肠癌肝转移癌细胞混悬液,种植术后13天行MRI检查,测量肿瘤体积V1,然后采取介入治疗措施:第14天时采取单纯TACE治疗(丝裂霉素(碘油(降解淀粉);②第14天时采取单纯LITT治疗(Nd:YAG激光);③联合TACE(第14天时)和LITT治疗(第21天时)。第28天时再次行MRI检查以确定肿瘤体积V2变化,比较肝肿瘤体积生长率V2/V1。结果:介入治疗后肿瘤体积与治疗前肿瘤体积之比分别为A组5.42、B组6.14、C组3.15。与对照组A组和B组相比,采取C组即TACE联合LITT的治疗方案明显抑制肝肿瘤的生长(Bonferroui检验,P<0.01)。结论:联合TACE和LITT的综合介入治疗方法与单纯TACE以及LITT相比,能明显抑制大鼠肝转移癌的生长。

Objective：To assess the effect of combined chemoembolization （TACE） and laser-induced thermotherapy （LITT） in an animal model of liver metastasis from colon carcinoma. Methods： Liver metastases were implanted in 30 WAG rats by subcapsular injection of cells from a colorectal cancer strain （CC531） （day 0）. The animals were randomized into two control groups （group A and group B） and one therapy group （group C）. Then the following protocols of interventional procedure were performed：Group A （TACE alone,n=10,at day 14）：After laparotomy and retrograde placement of a microcatheter into the gastroduodenal artery, mitomycin （0. 1 rag）, lipiodol （0. 1 ml） and degradable starch microspheres （DSM,5.0mg） were injected with a sandwich technique in 20 minutes;Group B （LITT alone,n= 10,at day 14）：Tumors were exposed to 1064nm Nd：YAG laser light at 2 watts for 5 minutes from a diffuser tip applicator placed in the tumor; Group C （TACE＋LITT,n=10）：The combined treatment of TACE and LITT was performed at day 14 and 21 after implantation, respectively. The tumor volumes before （V1） （at day 13） and after treatment （V2） （at day 28） were determined by MRI and the mean tumor growth ratio （V2/V1） was calculated. Results： The mean tumor volume V1 and V2 were 0. 1100cm^3 and 0. 5988cm^3 in group A, 0. 1108cm^3 and 0. 6763cm^3 in group B,0. 1110cm^3 and 0. 3503cm^3 in group C,respectively. The mean tumor growth ratio （V2/V1） was 5.42 in group A, 6.14 in group B and 3.15 in group C, respectively. Compared with the control groups A and B,group C showed all significant inhibition of tumor growth by Bonferroui test （P〈0.01 both）. Conclusion：The combined interventional treatment of TACE and LITT retards the growth of liver metastasis more significantly compared to either TACE or LITT alone in rats.