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首页> 外文期刊>Annals of surgical oncology >Biliary sclerosis after hepatic arterial infusion pump chemotherapy for patients with colorectal cancer liver metastasis: Incidence, clinical features, and risk factors
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Biliary sclerosis after hepatic arterial infusion pump chemotherapy for patients with colorectal cancer liver metastasis: Incidence, clinical features, and risk factors

机译：大肠癌肝转移患者肝动脉输注泵化疗后胆道硬化症的发生率，临床特征和危险因素

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Background. Hepatic arterial infusion pump chemotherapy (HAIPC) contributes to the prolonged survival of selected patients with colorectal cancer liver metastases (CRCLM). The most clinically important adverse event after HAIPC with floxuridine (FUDR) is biliary sclerosis (BS). Little is known about the etiology of BS. Methods. HAIPC was administered to 475 consecutive patients who received HAIPC on prospective protocols from 1991 to 2008. The incidence, clinical features, variables related to demographics, comorbidity, medical history, CRCLM, surgery, chemotherapy, and laboratory data were reviewed. An analysis of factors potentially associated with BS, defined as a biliary stricture related to HAIPC requiring stent placement, was performed. Results. The incidence of BS was 5.5% (16 of 293) in patients receiving HAIPC as an adjuvant therapy after hepatectomy, and 2% (2 of 100) in patients receiving HAIPC with FUDR for unresectable disease. The common hepatic duct was the site most frequently affected (87.5%). In patients receiving adjuvant HAIPC, BS was associated with abnormal postoperative flow scans (18.8% vs. 1.8%, P = 0.006), postoperative infectious complications (50.0% vs. 14.8%, P = 0.002), and larger dose/cycle/weight of FUDR (2.6 vs. 2.0 mg/cycle/kg, P = 0.025) than patients without BS. No patient died directly of BS. Median survival was not compromised by the development of BS (BS vs. non-BS: 61.0 months [range 6.2-171.6 months] vs. 47.2 months [range 2.4-200.8 months], P = 0.316, respectively). Conclusions. BS is an uncommon complication after HAIPC and does not compromise survival if adequately salvaged by stenting or dilatation. Surgical complications as well as type and dose of intra-arterial chemotherapy may contribute to the development of BS.
机译：背景。肝动脉输液泵化学疗法（HAIPC）有助于选择的结直肠癌肝转移患者（CRCLM）的延长生存期。 HAIPC与氟尿苷（FUDR）发生后最重要的临床不良事件是胆汁性硬化症（BS）。关于BS的病因知之甚少。方法。从1991年至2008年，对475例接受前瞻性治疗方案接受HAIPC的连续患者进行了HAIPC治疗。回顾了其发生率，临床特征，与人口统计学，合并症，病史，CRCLM，手术，化学疗法和实验室数据有关的变量。进行了可能与BS相关的因素的分析，定义为与HAIPC相关的胆道狭窄需要放置支架。结果。肝切除术后接受HAIPC辅助治疗的患者BS的发生率为5.5％（293例中的16例），接受HAIDR FUDR治疗的不可切除疾病的BS发生率为2％（100例中的2例）。肝总管是受累最频繁的部位（87.5％）。在接受HAIPC辅助治疗的患者中，BS与术后血流扫描异常（18.8％对1.8％，P = 0.006），术后感染并发症（50.0％对14.8％，P = 0.002）以及较大的剂量/周期/体重相关FUDR的发生率（2.6 vs. 2.0 mg / cycle / kg，P = 0.025）比无BS的患者高。没有患者直接死于BS。中位生存期不受BS发展的影响（BS与非BS：61.0个月（6.2-171.6个月范围）与47.2个月（2.4-200.8个月范围），P = 0.316）。结论BS是HAIPC后罕见的并发症，如果通过支架置入术或扩张术充分挽救，则不会损害生存。外科手术并发症以及动脉内化疗的类型和剂量可能有助于BS的发展。

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