肝动脉介入联合全身静脉化疗预防大肠癌术后肝转移的临床研究

The prevention effect of hepatic arterial infusion combined with systemic chemotherapy on liver metastasis of colorectal cancer

目的探讨肝动脉介入联合全身静脉化疗预防大肠癌术后肝转移的疗效及毒副反应。方法治疗组48例大肠癌术后病人,术后3周行肝动脉介入联合全身静脉化疗6个周期,药物奥沙利铂130 mg/m2,亚叶酸钙300 mg/m2,氟脲苷(FUDR)500/m2,羟基喜树碱15～20 mg/m2,对照组38例病人则仅予以同样药物全身静脉化疗6个疗程。所有病例术前、术后、化疗前后均行影像学检查以评价疗效,随访48个月,评价肝转移及毒副反应。结果肝转移率:治疗组4.17%(2/48)、对照组28.95%(11/38),近期疗效显著,两组均未发生化疗引起的造血系统、肝肾功能的损害,无化疗相关死亡,两组之间呈显著性差异(P<0.01)。结论肝动脉介入联合全身静脉化疗近期可有效预防大肠癌术后肝转移的发生,毒副反应小,安全有效。

Objective To investigate the prevention effect and side effects of hepatic arterial infusion combined with systemic chemotherapy on liver metastasis of colorectal cancer.Methods 48 postoperative colorectal cancer patients in the research group were given regular 6 cycles of chemotherapy plus hepatic arterial infusion chemotherapy 3 weeks after the operation（Oxaliplatin 130 mg/m2,leucovorin 300 mg/m2,FUDR 500 mg/m2,HCPT 15~20 mg/m2）,while the 38 postoperative colorectal cancer patients in the control group only received the same regular chemotherapy.The imaging detection was used to evaluate the therapeutic effect.All patients were followed up for 48 months and the liver metastasis status and side effects were evaluated.Results The liver metastasis rates in the research group and control group were 4.17%（2/48） and 28.95%（11/38）,respectively,and the difference was significant（P0.01）.No hematopoietic system,liver and kidney function damage and chemotherapy related death were observed.Conclusion Hepatic arterial infusion combined with systemic chemotherapy can prevent the liver metastasis of colorectal cancer with minor toxicity.