Abstract:
Hepatic artery infusion chemotherapy (HAIC) is a popular treatment modality for the treatment of colorectal liver metastasis (CRLM). The aim of this study was to determine the feasibility of HAIC for high-risk resected CRLM delivered using repeated femoral puncture and delivering 5-fluorouracil infusional chemotherapy along with systemic adjuvant chemotherapy. The present study is a retrospective review of a prospectively maintained database. All patients who underwent HAIC for colorectal liver metastases between July 2022 and July 2023 were included. A total of 12 patients were included in the study of which 11 completed four sessions as planned. The median age was 47 (29-73) years with nine male (81%) and two female (18%) patients. Rectum (n = 7, 63%) was the most common primary location. All patients received systemic chemotherapy with 5-fluorouracil-based regimens prior to HAIC (median 12 cycles). The median number of metastasis was 2 (1-8). Eight patients had metastasis in unilobar distribution (73%). On completion of HAIC treatment, nine patients (64%) were completely disease free with a median follow-up of 8 months. None of the patients experienced any immediate adverse events during or after completion of the procedure. Conventional HAIC comes with various challenges such as unavailability of the agent floxuridine and the specialized HAIC pump. Percutaneous HAIC has a lower chance of infection. The delivery of HAIC using repeated femoral punctures and 5FU chemotherapy was successful in over 90% of the patients making it a feasible option in the treatment of CRLM.
摘要:
肝动脉灌注化疗(HAIC)是治疗结直肠肝转移(CRLM)的一种流行治疗方式。这项研究的目的是确定HAIC用于通过反复股动脉穿刺和5-氟尿嘧啶输注化疗以及全身辅助化疗进行高风险切除的CRLM的可行性。本研究是对前瞻性维护的数据库的回顾性回顾。所有在2022年7月至2023年7月期间因结直肠癌肝转移而接受HAIC治疗的患者均包括在内。共有12名患者被纳入研究,其中11名按计划完成了4个疗程。中位年龄为47(29-73)岁,其中9名男性(81%)和2名女性(18%)患者。直肠(n=7,63%)是最常见的主要位置。所有患者在HAIC之前接受以5-氟尿嘧啶为基础的全身化疗方案(中位12个周期)。中位转移数为2(1-8)。8例患者单叶分布有转移(73%)。HAIC治疗完成后,9例患者(64%)完全无病,中位随访时间为8个月.在手术期间或完成后,没有患者发生任何即时不良事件。常规的HAIC带来了各种挑战,例如无法获得氟尿苷和专用HAIC泵。经皮HAIC具有较低的感染机会。使用反复股骨穿刺和5FU化疗的HAIC在90%以上的患者中成功递送,使其成为CRLM治疗的可行选择。