INTESTINE Vol.7 No.3(4-5-2)

特集名 大腸癌肝転移の画像診断と治療
題名 治療 (5) 肝動注療法 b. 切除不能大腸癌肝転移に対する肝局所化学療法
発刊年月 2003年 05月
著者 中島 祥介 奈良県立医科大学第一外科
著者 長尾 美津男 奈良県立医科大学第一外科
【 要旨 】 要旨はありません。
Theme Recent advances in the diagnostic imaging and the treatment of liver metastates from colorectal cancer
Title Hepatic locoregional chemotherapy on unresectable hepatic metastases from colorectal cancer
Author Yoshiyuki Nakajima First Department of Surgery, Nara Medical University
Author Mitsuo Nagao First Department of Surgery, Nara Medical University
[ Summary ] We discussed the effectiveness of hepatic locoregional chemotherapy with exclusive of weekly high doses of 5 FU through the hepatic artery (WHF) on unresectable hepatic metastases patients with colorectal cancer. Hepatic arterial infusion chemotherapy (HAIC), using 5 FU (250 to 500mg/body) and CDDP (5 to 10mg/body), obtained a response rate of 70% and a median survival time of 23.5 months in our 10 cases. Serious toxicities were recognized in four cases and specific toxicity caused by HAIC, liver abscess due to cholangitis, occurred in two cases. HAIC using IL-2, 5 FU and MMC has also been reported to be another hopeful protocol, with a response rate of 66.7%. Isolated hepatic chemoperfusion is in progress as another form of hepatic locoregional chemo therapy. The method can be divided broadly intotwo categories. One is percutaneous isolated hepatic perfusion under hepatic venous isolation and charcoal hemoperfusion without any surgical procedure. The other is isolated hepatic hyperthermo chemoperfusion via a completely isolated vascular recirculating perfusion circuit, using a surgical procedure. It would be problem to be solved that all of locoregional chemotherapy can effectively control bepatic lesions, but not extrahepatic ones.