经肝动脉输液泵化疗在结直肠癌肝转移治疗中的临床应用进展

Hepatic arterial infusion pump chemotherapy in treatment of patients with colorectal liver metastases

肝脏是结直肠癌血行转移最主要的靶器官,约有50%结直肠癌最终会发生肝转移,肝转移已经成为影响结直肠癌患者预后的重要不利因素。肝动脉是结直肠癌肝转移瘤的主要供血动脉,经肝动脉灌注化疗药物可提高肿瘤局部药物浓度和化疗效果,植入式输液泵可更简便地为患者提供长期灌注化疗。经肝动脉输液泵灌注化疗在术前转化降期治疗和术后辅助治疗方面展现出显著的疗效,可有效提高结直肠癌肝转移肿瘤手术切除的可行性和降低术后复发率。经肝动脉输液泵氟脲苷化疗可作为结直肠癌肝转移的二、三线治疗方案,联合全身化疗和靶向治疗等可为患者带来较好的生存获益。本文综述了经肝动脉输液泵化疗治疗结直肠癌肝转移临床应用及研究进展。

The liver is the most common organ of hematogenous metastasis of colorectal cancer,and about 50%of colorectal cancers will eventually develop liver metastasis,which have become an important untoward factor affecting the survival and prognosis of patients with colorectal cancer.The hepatic artery is the main blood supply vessel for colorectal liver metastases(CRLM),and direct infusion of chemotherapeutic agents through the hepatic artery can improve the local drug concentration and anti-tumor effects.The implantable infusion pumps provide convenient tunnels for infusion chemotherapy easily.The hepatic arterial infusion pump(HAIP)chemotherapy has shown a promising effect in preoperative transformation or downstage of tumors and postoperative adjuvant therapy,which can effectively improve the feasibility of surgical resection of CRLM and reduce the postoperative recurrence rate.The fluorouridine chemotherapy by HAIP can be applied as second or third lines of treatment for patients with CRLM.The HAIP and systemic chemotherapy combination plus targeted therapy can bring better survival benefits for patients in this setting.This article will review and discuss the clinical applications and advances of HAIP chemotherapy in the surgical treatment of CRLM.