经肝动脉药盒持续灌注氟脲苷与地塞米松治疗化疗抵抗的结直肠癌肝转移的疗效与安全性分析

Efficacy and safety of hepatic arterial infusion fluorouracil plus dexamethasone in patients with chemotherapy-refractory liver metastases from colorectal cancer

目的探讨经肝动脉药盒灌注氟脲苷与地塞米松治疗化疗抵抗的结直肠癌肝转移的疗效及安全性。方法对23例经过至少二线化疗失败的结直肠癌肝转移患者采用介入放射方法植入肝动脉药盒,术后第2天开始经药盒灌注氟脲苷与地塞米松,对其治疗疗效、毒副反应及生存状态进行回顾性分析。结果 23例患者的肝内疾病控制率为69.6%,其中部分缓解10例(43.5%),稳定6例(26.1%);4例患者转化为可手术切除,转化率为17.4%。中位肝内无进展生存时间为(9.0±1.8)月,中位总生存时间为(14.0±1.8)月。结论经肝动脉药盒灌注氟脲苷与地塞米松可作为化疗抵抗的结直肠癌肝转移的补救治疗,并可能使部分患者转化为可手术切除,从而获得长期生存的机会。

Objective To evaluate the efficacy and safety of the hepatic arterial infusion （HAI） fluorouracil （FUDR） plus dexamethasone for patients with chemotherapy-refractory colorectal cancer liver metastases（CRCLM）. Methods HAI catheter systems were implanted by an innovative radiological method in 23 CRCLM patients who had progressive diseases after at least second-line systemic chemotherapy. HAI FUDR and dexamethasone were delivered in the next day after catheter implantation. The short-term effects, adverse events related to treatments and survival data were analyzed retrospectively. Results The hepatic disease control rate was 69.6%, including partial responses 43.5%and stable disease 26.1%. The median hepatic progression-free survival and overall survival was （9.0±1.8） and （14.0±1.8） months respectively. Four patients （17.4%） were converted to resectable. Conclusion HAI FUDR plus dexamthasone is an effective salvage treatment for patients with chemotherapy-refractory colorectal cancer liver metastases, and may render some patients convert to resectable and obtain a chance of longer survival.