ObjectiveTo summarize the research progress and clinical efficacy of hepatic artery infusion chemotherapy in the treatment of colorectal cancer liver metastasis.MethodThe literatures of hepatic artery infusion chemotherapy for colorectal cancer liver metastasis were collected and reviewed.ResultsThe incidence of colorectal cancer liver metastasis was high, which affected the prognosis of patients. Surgical treatment was the preferred treatment for colorectal cancer liver metastasis. Hepatic arterial infusion chemotherapy could be used for preoperative neoadjuvant therapy and postoperative adjuvant therapy.ConclusionsHepatic arterial infusion chemotherapy is an effective local treatment for colorectal cancer liver metastasis and can be used as a supplement to surgical treatment. Compared with systemic chemotherapy, hepatic arterial infusion chemotherapy combined with systemic chemotherapy can improve the overall survival and disease-free survival, reduce the risk of intrahepatic recurrence, and improve the prognosis of patients.
Abstract: Objective To summarize the method and effective result of thoracoscopic intrapleural perfusion hyperthermochemotherapy(TIPHC) for treating malignant pleural effusion caused by lung cancer. Methods Fiftyeight patients with malignant pleural effusion caused by lung cancer were randomly divided into therapeutic group(30 cases) and control group(28 cases) between February 1999 and March 2005. Pleural biopsy and TIPHC under general ansthesia with unilateral ventilation were performed in the therapeutic group, and intrapleural injection of cisplatin was administered in control group after drainage of pleural effusion. The effect on malignant pleural effusion， the change for the concentration of carcinoembryonic antigen(CEA)， cytokeratin-19 fragments (CYFRA21-1)， neuronspecific enolase (NSE) and the side effect were compared before and after the treatment. Results The therapeutic group achieved total response rate of 100.0%, but only 53.6% in control group, with significant difference(χ 2=3.863, Plt;0.05). Furthermore, the concentration of CEA， CYFRA21-1， NSE in therapeutic group dramatically descended than control group(t=2.562,Plt;0.05). But there was no significant difference in side effect (Pgt;0.05). The pathological diagnosis of all the patients were determined in the therapeutic group. Conclusion TIPHC has the advantage of both diagnosis and treatment of malignant pleural effusions. It is safe and effective, and also able to determine the diagnosis. Furthermore, it offers the superiority of small wound， best visualization and convenient pleural biopsy.
Objective To observe the toxic and side effects during the continuous hyperthermic peritoneal perfusion chemotherapy (CHPPC).Methods Abdominal paracentesis and catheterization were performed under ultrasound guidance, then CHPPC was carried out, which was in temperature of 42-44 ℃ for 1 h. The changes of body temperature, heart rate, blood pressure, saturation of blood oxygen and respiratory frequency were recorded in 109 patients during and after perfusion, meanwhile symptoms and physical signs of abdominal region and system status such as abdominal tenderness, rebound tenderness were observed. Results There were no significant differences of body temperature, heart rate, blood pressure, saturation of blood oxygen or respiratory frequency between before and after perfusion (Pgt;0.05). There were 25 patients with abdominal pain, but in which only 3 patients with symptoms of acute abdomen, 26 patients with gastrointestinal symptoms, 20 patients with myelosuppression, and others (22 cases) with aches of puncture position which were released by symptomatic treatment. Conclusion There are less toxic and side effect and better tolerance in patients with CHPPC application 1 month after operation.
ObjectiveTo investigate the curative effects of cytoreductive surgery (CRS) combined with hyper-thermic intraperitoneal chemotherapy (HIPEC) for treating the hepatocellular carcinoma with peritoneal metastasis. MethodsThe clinical data of 80 cases of hepatocellular carcinoma with peritoneal metastasis who were treated in our hospital from January 2004 to January 2012 were collected, and were classified into observation group (n=40) and control group (n=40) according to the treatment. Case of observation group received CRS+HIPEC, and cases of control group received CRS+conventional intraperitoneal injection of chemotherapy. Then the comparison of clinical effect and prog-nosis was performed. ResultsIn observation group, the results of completeness of cytoreduction (CC) grade was:31 cases in grade 0, 6 cases in grade 1, and 3 cases in grade 2. In control group, the results of CC grade was:32 cases in grade 0, 6 cases in grade 1, and 2 cases in grade 3. There was no significant difference between 2 groups in the CC grade (P=0.213). In addition, there were no significant differences between observation group and control group in operation time (6.8 hours vs. 6.5 hours), hospital stay (17.3 days vs.18.7 days), and incidence of adverse reactions[70.0% (28/40) vs. 60.0% (24/40)], P>0.05. All of the cases of observation group and control group were followed up for 10-61 months (average of 42.5 months) and 6-49 months (average of 30.2 months) respectively. During the follow up period, in observation group, there were 18 cases died, 12 cases suffered from recurrence, 5 cases suffered from metastasis, and the rest of 5 cases survived; in the control group, there were 26 cases died, 9 cases suffered from recurrence, and 5 cases suffered from metastasis. However, the survival situation was better in observation group than that of control group (P<0.01). ConclusionCombining CRS and HIPEC for treating hepatocellular carcinoma with peritoneal metastasis was safe and effective, which would be widely applied.
Objective To explore the feasibility, safety, efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer.Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy, intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue, reduce the systemic toxic side effects, increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy, as an adjuvant treatment of advanced gastric cancer, has been gradually applied to clinic because of the definite curative effect, which is worth popularizing. However, it needs systemic researches and accumulation of cases.
Objective To evaluate the effect of regiono-perfusional chemotherapy of pancreatic adenocarcinoma, and to seek the management of its complications. MethodsThirty-six patients with unresectable pancreatic adenocarcinoma received selectively intra-arterial catheterization and perfused with 5-Fu, ADM, DDP. Results Six patients had complete response, 15 partial response, and one underwent radical resection subsequently. Cmplications occurred in 14 patients with 2 patients died of complications.Conclusion Regiono-perfusional chemotherapy of pancreatic adenocarcinoma is effective, but the complications can not be neglected.
【摘要】目的 观察介入灌注化疗栓塞后手术切除直肠癌的临床疗效。方法 本组31例患者于术前先行区域性动脉灌注化疗加栓塞术，然后多在3～7 d内限期行直肠癌根治术，其中行Dixon术23例， Miles术7例， Hartmann术1例。结果 本组患者术中出血少，肿瘤剥离容易，一般无须输血； 患者术后的肿瘤复发率、转移率和死亡率均优于我科同期术前未行区域性动脉灌注化疗加栓塞术而直接接受手术治疗者。结论 先行区域性动脉灌注化疗栓塞术后再行直肠癌根治性切除，近期疗效好，不失为直肠癌综合治疗的一种新的有效方法。
摘要:目的:探讨晚期食管癌切除、纵隔淋巴结清扫及术中纵隔热灌注化疗对残留于气管、支气管、胸主动脉、奇静脉等器官的癌性肉眼微小病灶治疗效果。方法:选择食管癌病变浸润超过外膜层外侵至气管、支气管、胸主动脉、奇静脉等器官患者112例，随机分为两组:治疗组56例,术中42～43℃无菌蒸馏水2000～2500 mL加入顺铂(DDP)150 mg及氟尿嘧啶(5FU)1200 mg在体外循环下行纵隔热灌注化疗40 min;对照组56例,术中未进行纵隔热灌注化疗。结果:治疗组术后第一年有6例出现纵隔区域肿瘤复发及淋巴结转移,术后第二年有11例纵隔区域肿瘤复发及淋巴结转移;对照组术后第一年有14例出现纵隔区域肿瘤复发及淋巴结转移,术后第二年23例出现纵隔区域肿瘤复发及淋巴结转移。结论:晚期食管癌术中纵隔热灌注化疗可明显减少或延迟纵隔区域肿瘤复发及淋巴转移,提高术后第一至第二年生存率。Abstract: Objective: To explore the advanced esophageal cancer resection, mediastinum, lymph node dissection, mediastinum, hot infusion chemoembolization and clinical observation of residual heat infusion chemoembolization and trachea, or the thoracic aorta, bronchus, eye cancer organs such as intravenous of tiny lesions therapeutic effect. Methods: Select esophageal lesions than the outer membrane layer of infiltrating the trachea and bronchus to the thoracic aorta, and 112 cases of patients with venous organs such as random points to two groups: treatment group treated with perfusion of 56 cases at 4243 degrees Celsius sterile 2000 mL distilled water 2500 mL ~ (DDP) joined cisplatin 150 mg, 5fluorouracil (5FU 1200 mg) in extracorporeal circulation downlink mediastinal hot perfusion 40 minutes, control group treated with perfusion of 56 cases without mediastinal hot perfusion chemotherapy. Results: Treatment group in 6 cases occured after first mediastinal tumor recurrence and regional lymph node metastases after 11 cases, the regional recurrence and lymphatic metastasis mediastinal, control group first fill after 14 cases mediastinal tumor recurrence and bureau of regional lymph node metastasis appeared in 23 cases, surgery between regional tumor locally recurrent lymph node metastases. Conclusion: Advanced esophageal intraoperative mediastinal hot perfusion chemotherapy can obviously reduce or delay mediastinal tumor recurrence and regional lymph node metastases, raise the firstsurial.
目的 探讨临床治疗原发性肝癌合并门静脉癌栓的有效方法及疗效。方法 对我院2008年1月至2010年1月期间收治的29例原发性肝癌合并门静脉癌栓患者的临床资料进行回顾性分析,并按治疗方法的不同将患者分为经动脉导管栓塞术（TAE）治疗组和TAE＋门静脉灌注化疗治疗组，比较2组患者的治疗效果。结果 TAE治疗组治疗有效率、门静脉癌栓缩小率和AFP转阴率分别为43.75%、18.75%和37.50%，TAE＋门静脉灌注治疗组分别为76.92%、61.54%和61.54%，2组比较后者优于前者（P＜0.05）。TAE＋门静脉灌注治疗组患者治疗后半年及1年生存率高于TAE治疗组（P＜0.05）。TAE治疗组患者生存时间为４～18个月，中位生存期为8个月；TAE＋门静脉灌注治疗组患者生存时间为5～18个月，中位生存期为11个月。结论 TAE＋门静脉灌注化疗是一种安全可行的治疗方法，可延长原发性肝癌合并门静脉癌栓患者的生存时间。