【摘要】 目的　评价经动脉化疗栓塞治疗大肠癌肝转移的疗效。方法　经股动脉穿刺 ,行选择性肝动脉插管注入化疗栓塞剂 ,治疗曾经一次或多次全身化疗无效的大肠癌肝脏转移 43例。治疗次数 1～ 3次 ,间隔 4～ 8周。结果　治疗后肿瘤密度降低率≥ 75 % (P <0 .0 5 ) ,或肿瘤缩小率≥ 2 5 %者达 6 5 .1% (2 8/ 43,P <0 .0 1)。 88.9%(2 4/ 2 7)的病例癌胚抗原 (CEA)治疗后下降≥ 2 5 % (P <0 .0 1)。 43例病人中位生存期为化疗栓塞治疗后 9.4月 ,肝转移首次诊断后 2 9.7月。常见毒副反应有 :发热、右上腹疼痛、恶心、呕吐和无力 ;血液毒性包括白细胞下降 ,贫血和血小板减少。除无力症状可持续较长时间外 ,上述毒副反应多可在 1～ 5d内消除。结论　对于其他治疗方法无效的大肠癌肝转移瘤 ,化疗栓塞是一种可行的治疗方法 ,肿瘤血供丰富者 ,接受 3次或更多次化疗栓塞者 ,效果更好更多还原

【Abstract】 Objective To investigate the therapeutic effect of regional chemoembolization for patients with metastatic liver cancer from colorectal carcinoma who had experienced failure with one or more systemic treatments.Methods 43 patients who met the study entry criteria underwent one or three hepatic artery chemoembolization (HACE). The chemoembolization regimen consisted of an injection of lipiodol with cisplatin, doxoru bicin and mitomycin C. Repeat treatments were performed at 4- to 8-weeks intervals.Results Radiologic responses, as measured by a at least 75% decrease in lesion density or a 25% decrease in lesion size, occurred in 65.1% of the cases. A decrease of at least 25% of baseline carcinoembryonic antigen (CEA) level occurred in 88.9% of the cases. Median survival time was 9.4 months after HACE and 29.7 months after the initial diagnosis of metastasis to the liver. Common toxicities included fever >38℃( 81.4%), pain in right upper quadrant (100%), nausea, vomiting and lethargy. Hematologic toxicities included leucocytosis, anemia and thrombocytopenia.Conclusion HACE is a feasible treatment modality for patients with metastatic liver cancer from colorectal carcinoma who had experienced failure with other systemic treatments. It results in high response rate with transient mild to moderate toxicity. Patients with hypervascular lesions undergo three or more HACE may show more clinical benefits.更多还原