Таким образом, установка ХИИС предпочтительна как этап внутриполостной радикальной или циторедуктивной операции. У пациентов с нерезектабельным злокачественным поражением печени целесообразна установка ЧИИС, которая является относительно простой, безопасной и менее травматичной операцией. Использование имплантируемых артериальных систем делает возможным проведение регулярных циклов ХИПА. Имплантируемые системы не ограничивают активность пациента и не ухудшают качество жизни. Первые клинические данные позволяют надеяться на улучшение результатов ХИПА у больных с метастазами колоректального рака в печень.
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INTRAARTERIAL CHEMOTHERAPY USING IMPLANTABLE CATHETER-PORT SYSTEM IN THE TREATMENT OF PATIENTS WITH COLORECTAL LIVER METASTASES
Central Research Institute of Roentgeno-Radiology, Ministry of Health of the RF, St.Peterburg
We have evaluated the potential and initial clinical results of catheter-port system implantation using surgical or interventional radiological approaches for continuous hepatic artery infusion chemotherapy in the treatment of colorectal liver metastases. Since December 2001 to June 2006, thirty two patients with colorectal liver metastases were treated with implantable catheter-port system. Laparotomic approache was used in 17 and percutaneous transfemoral implantation in 15 patients. No complications occurred during the implantation procedures. The mean number of chemotherapy cycles per patient was 4 (2 to 11). The mean follow-up period was 241 (57-730) days. At present, 21 patients are alive within 5 and 28 months and they continue to receive intraarterial chemotherapy, while 11 patients died in 4 to 22 months due to tumor progression. The common 1-year survival is 76,5%.
Initial results showed that surgical implantation of the catheter-port system is reasonable when it is combined with cytoreductive operation. Percutaneous transfemoral implantation is feasible and potentially effective for the treatment of patients with unresectable colorectal liver metastases.
INDEX TERMS: hepatic artery infusion - colorectal liver metastases - catheter-port system