[Complication of reservoir hepatic artery infusion chemotherapy and additional treatments].
In 54 patients who underwent hepatic artery infusion chemotherapy for hepatic tumors at our hospital between January 1990 and December 1996, we investigated the complications of this therapy and the therapeutic techniques following its discontinuation. The arterial infusion was discontinued in 36 of the 54 patients; 13 due to death (mean survival period: 15.7 months), and 23 in whom occlusion of the reservoir, etc. made it impossible to use arterial infusion (mean period of use: 13.8 months), and the minimum duration of use was 41 days and maximum duration of use 992 days. The most common complication of the reservoir hepatic artery infusion was reservoir occlusion (14.8%). Another serious complication was reservoir deviation outside the blood vessel in two patients; deviation in to the gastric lumen in one case and intraperitoneal deviation in the other. Four hepatocellular carcinoma patients, in whom it became impossible to use the reservoir due to its occlusion, underwent re-hepatectomy. Three of them survived for more than two years following supplemental local therapy, including subarterial injection, TAE, PEIT, microwave tumor coagulation (MTC). Of four patients with colon cancer metastasizing to the liver, one could undergo re-hepatectomy, one received subarterial injection, and two have survived without relapse. Two of three patients with breast cancer underwent systemic chemotherapy and endocrine therapy successfully, while the third one underwent subarterial injection and TAE, and is still under observation. Hepatic artery infusion should sometimes be discontinued owing to complications caused by various factors. Even if it becomes impossible to use the reservoir, local therapeutic techniques, including re-hepatectomy, TAE, PEIT, MTC, etc., may be performed in some patients. These findings suggest that it is necessary to review the interdisciplinary treatment so as to be appropriate to the primary disease.
Niinobu
T
T
Dept. of Surgery, Toyonaka Municipal Hospital.
Shibata
T
T
Shibata
N
N
Takada
T
T
Kitada
M
M
Tsukahara
Y
Y
Iihara
K
K
Ikeda
K
K
Ogawa
M
M
Hayashi
N
N
Takami
M
M
Ishida
T
T
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D004621:Embolization, Therapeutic; D015251:Epirubicin / Q000008:administration & dosage; D004866:Equipment Contamination; D004868:Equipment Failure; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007261:Infusions, Intra-Arterial / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D015251:Epirubicin; D005472:Fluorouracil