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首页> 美国卫生研究院文献>Current Oncology >Hepatic arterial infusion pump chemotherapy for colorectal liver metastases: an old technology in a new era
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Hepatic arterial infusion pump chemotherapy for colorectal liver metastases: an old technology in a new era

机译：肝动脉输注泵化学疗法治疗大肠肝转移：新时代的旧技术

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Aggressive treatment of colorectal cancer (crc) liver metastases can yield long-term survival and cure. Unfortunately, most patients present with technically unresectable metastases; conventional therapy in such patients consists of systemic therapy. Despite advances in the effectiveness of systemic therapy in the first-line setting, the tumour response rate and median survival remain low in the second-line setting. The preferential blood supply from the hepatic artery to crc liver metastases allows for excellent regional delivery of chemotherapy. Here, we review efficacy and safety data for hepatic artery infusion (hai) pump chemotherapy in patients with metastatic crc from the 5-fluorouracil era and from the era of modern chemotherapy.In selected patients with liver-only or liver-dominant disease who have progressed on first-line chemotherapy, hai combined with systemic agents is a viable therapeutic option when performed at experienced centres. Furthermore, significantly improved survival has been demonstrated with adjuvant hai therapy after liver resection in the phase iii setting. The complication rates and local toxicities associated with hai pump therapy are infrequent at experienced centres and can be managed with careful follow-up and early intervention. The major obstacles to the wide adoption of hai therapy include technical expertise for pump insertion and maintenance, and for floxuridine dose modification. The creation of formal preceptor-focused education and training in hai therapy for interdisciplinary medical professionals might encourage the creation and expansion of this liver-directed approach.
机译：积极治疗结直肠癌（crc）肝转移可以长期生存和治愈。不幸的是，大多数患者存在技术上无法切除的转移灶。这种患者的常规治疗包括全身治疗。尽管在一线治疗中全身治疗的有效性有所进步，但在二线治疗中肿瘤缓解率和中位生存率仍然很低。从肝动脉到crc肝转移的优先血液供应可以实现出色的区域化疗效果。在此，我们回顾了从5-氟尿嘧啶时代到现代化疗时代的转移性crc患者肝动脉输注（hai）泵化疗的疗效和安全性数据。随着一线化疗的进展，在经验丰富的中心进行的hai与全身性药物联合治疗是一种可行的治疗选择。此外，在iii期肝切除后，辅助hai治疗已证明生存率显着提高。在经验丰富的医疗中心，与HAI泵疗法相关的并发症发生率和局部毒性反应很少见，可以通过认真的随访和早期干预来控制。 hai疗法广泛采用的主要障碍包括泵插入和维护以及氟尿苷剂量调整的技术专长。为跨学科的医学专业人士提供以海普疗法为基础的正式的以受体为导向的教育和培训，这可能会鼓励这种以肝脏为导向的方法的创建和扩展。

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