中山大学学报（医学科学版）2011，Vol.32Issue(3)：348-354,7.
肝动脉灌注氟尿苷优化结直肠癌肝转移患者的化疗方案的探索性研究
A Pilot Study of Hepatic Arterial Infusion Floxuridine to Optimize Chemotherapy for Patients with Inoperable Liver Metastases from Colorectal Cancer
摘要
Abstract
[Objective]To observe the efficacy and safety of mFOLFOX systemic chemotherapy plus continually hepatic arterial infusion (HAI) of floxuridine (FUDR) in the patients with inoperable liver metastases from colorectal cancer. [Methods]Between July 2006 and May 2010, 48 patients underwent DSA-guided percutaneous implantation of port-catheter system (PCS), with catheter tip placed in proper hepatic artery. FUDR was delivered in a 14-day infusion at 0.1 - 0.2 mg/kg per day plus 25 mg dexamethasone via hepatic artery PCS. Systemic chemotherapy was delivered on day 1 and day 15 with dose of oxaliplatin 85 mg/m2, 5-FU 1400 mg/m2 and leucovorin 200 mg/m2. The treatment cycles was repeated 28 days later. All toxic effects were graded according to the National Cancer Institute Common Toxicity Criteria (version 3.0). Response was evaluated according to RECIST criteria every two cycles. Subgroup analysis was done not only by metastatic time order but also by previous history of chemotherapy and the dose of FUDR.[Results] 48 valuable patients had received at least 1 cycle of chemotherapy plus HAI FUDR. After a median follow-up of 13 months, no patients had complete response, 36 cases (75%) had partial response and 9 cases (18.7%) had stable disease. Patients in every subgroup received high response more than 63% (63%-85%). 12 patients were ultimately able to undergo surgery resection/ radiofrequency ablation. Common adverse events (AE) in 48 patients were 1 to 2 degrees of thrombocytopenia, neutropenia, nausea, vomiting and diarrhea, sensory peripheral neurotoxicity. Grade 3 AE was 8.33%. The quality of life was improved in 45 patients with non progress disease during treatment (P<0.01). [Conclusion]On the basis of mFOLFOX systemic chemotherapy, combination with HAI FUDR for treatment of patients with inoperable liver metastases from CRC is effective. This regimen has a higher objective response rate. And AE could be tolerated to keep the quality of life of patients. This promising chemotherapy regimen is worth to be advised.关键词
结直肠癌肝转移/肝动脉灌注/氟尿苷/生活质量Key words
colorectal cancer/ hepatic arterial infusion/ floxuridine/ quality of life分类
医药卫生引用本文复制引用
赵明,潘长穿,李旺,黄子林,王键鹏,李宇红,吴沛宏..肝动脉灌注氟尿苷优化结直肠癌肝转移患者的化疗方案的探索性研究[J].中山大学学报（医学科学版）,2011,32(3):348-354,7.基金项目
卫生部重大新药创制科技重大专项(2008ZX09312-002)卫生部重大新药创制科技重大专项(2008ZX09312-002) （2008ZX09312-002）
