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可载药微球加载伊立替康行经动脉化疗栓塞术治疗不可切除的结直肠癌肝转移-ag捕鱼平台

文字: 2017-5-11    浏览次数:1272    

 

         background: following failure of standard systemic chemotherapy, the role of hepatic transarterial therapy for colorectal hepatic metastasis continues to evolve as the experience with this technique matures. the aim of this study to gain a better understanding of the value of drug eluting bead therapy when administered to patients with unresectable colorectal hepatic metastasis.

        目的:由于不断出现标准全身化疗失败的情况,同时基于tace技术日渐成熟,经肝动脉治疗结直肠癌肝转移的地位在不断提升。本研究旨在更深入的认识运用可载药微球治疗不可切除结直肠癌肝转移患者的临床价值。

       methods: this was an open-label, multi-center, single arm study, of unresectable colorectal hepatic metastasis patients who had failed standard therapy from 10/2006-10/2008. patients received repeat embolizations with irinotecan loaded beads(max 100 mg per embolization) per treating physician"s discretion.

       材料和方法:本研究为开放、多中心、单臂研究,纳入2006年10月至2008年10月间接受标准化疗治疗失败的不可切除结直肠癌肝转移患者,根据主治医师的判断决定患者接受加载伊立替康微球栓塞治疗的次数(每次治疗最多加载100mg伊立替康)。

       results: fifty-five patients underwent 99 treatments using irinotecan drug eluting beads. the median number of total treatments per patient was 2(range of 1-5). median length of hospital stay was 23 hours(range 23 hours – 10 days). there were 30(30%) sessions associated with adverse reactions during or after the treatment. the median disease free and overall survival from the time of first treatment was 247 days and 343 days. six patients(10%) were downstaged from their original disease status. of these, four were treated with surgery and two with rfa. neither number of liver lesions, size of liver lesions or extent of liver replacement(<= 25% vs >25%) were predictors of overall survival. only the presence of extrahepatic disease(p = 0,001), extent of prior chemotherapy (failed 1st and 2nd line vs > 2 line failure)(p = 0,007) were predictors of overall survival in multivariate analysis.

      结果:55例患者共进行了99次加载伊立替康载药微球的治疗。每例患者的中位治疗次数为2次(范围1-5次),中位住院时长为23小时(范围23小时-10天),有30次(30%)的治疗在治疗过程中或治疗后发生了不良反应,自首次治疗的中位无疾病生存期和总生存期分别为247天和343天。6例患者(10%)获得了相较原始疾病状态的降期,期中4例患者接受了外科治疗,2例患者进行了射频消融(rfa)治疗。在多变量分析中,肝脏肿瘤病灶的数量、病灶的大小及肿瘤累及肝脏的程度(≤25%或>25%)都不是总生存期的预测因子。仅仅存在肝外疾病(p=0.001)、既往化疗的程度(一线、二线或>二线化疗失败)(p=0.001)是总生存期的预测因子。

       conclusion: chemoembolization using irinotecan loaded beads was safe and effective in the treatment of patients as demonstrated by a minimal complication rate and acceptable tumor response.

      结论:运用加载伊立替康的载药微球行化疗栓塞术治疗不可切除结直肠癌肝转移患者因可获得极低的并发症发生率及令人满意的肿瘤应答率而安全有效。