消化道肿瘤肝转移瘤介入治疗的规范性研究

The Standard Research of Interventional Therapy of Liver Metastases from Cancer of the Alimentary Tract

目的:探讨消化道肿瘤肝转移瘤介入治疗的效果及影响因素,从而试行提出介入治疗的规范。方法:对112例消化道肿瘤肝转移瘤行442次介入治疗。强调依病理分型、体表面积及体重综和考虑药物的选择及用量。对未切除原发灶的胃癌,胰腺癌患者同时行原发灶灌注化疗,对富血供肿瘤行化疗栓塞,乏血供肿瘤亦尽可能行化疗栓塞。结果:全组112例共行442次介入治疗,其中单纯灌注化疗187次,加碘油栓塞213次,加碘油及明胶海绵栓塞42次,使用微导管108例次。规范组平均有效率49.3%,0.5,1,2,3,5年生存率分别为84.9%,71.7%,32.9%,7.1%,2.4%。对照组平均有效率40.1%,0.5,1,2,3,5年生存率分别为80.5%,62.9%,21.6%,5.0%,0%。经统计学分析,规范组在平均有效率,1,2年生存率方面比对照组有显著提高(P<0.05)。结论:肝动脉介入治疗消化道肿瘤肝转移瘤仍是目前首选的治疗方法。依病理分型选择化疗药物,富血供和超选择微导管技术对治疗效果有重要影响,规范性操作能提高治疗的有效率,减少并发症,降低副反应,改善患者生活质量,在一定程度上延长生存期。

Objective： To evaluate the efficacy of interventional therapy in the treatment of liver metastases from alimentary tract cancer. And to try. to raise the standard of interventional therapy.Method： A total of 112 patients with unresectable liver metastases from alimentary tract cancer was treated 442 times by interventional therapy. We simultaneous assessment the effects of the pathological typing, size of body and weight .No ectomize primarily gastric cancer,pancreatic cancer was performed infusion chemotherapy on liver metastases and primarily tumor; It was performed chemoembolization on vascular abundant turnout and asfar as possible on vascular poverty tumour.Results： Of the 442 times, only infusion chemotherapy was performed at 187 times, and infusion chemotherapy and lipiodol embolization at 213 times. lipiodol and galatin sponege-embolization was carried out at 42 times and vascular abundant 108 times. The 0.5-, 1-, 2-, 3- and 5 -year survival rate of standard group was 84.9%, 71.7%, 32,9%, 7.1% and 2.4%, respectively; the control group was 80.5%,62.9%,21.6%,5.0%,0% （1-, 2-year survival rate of standard group vs control group P〉0.05） o Conclusions： Treatment by hepatic artery interventional therapy is the first method to patients with liver metastases from alimentarytractcancer. Pathological typing, vascular abundant ,vascular abundant and standard therapy is important to the result of therapy and can decrease complication and side effect.