ABSTRACT
Objective To investigate the therapeutic methods and curative effect of combined interven-tional therapy on hepatic metastasis from colorectal cancer. Methods Hepatic artery angiography and port-calheter-system( PCS) were undertaken in 35 cases of liver metastasis from colorectal cancers. Therapeutic measare were divided into transcatheter arterial infusion(TAl) in 10 cases and transcatheter arterial emboliza-tion(TAE) in 25 cases according to their angiographic features. Drugs included oxalic acid platinum, CPT11 , MMC and 5-Fu + CF. Laser ablation under the CT guidance was taken after 2-3 courses of treatment, including 9 cases of ethanol ablation besides laser ablation. The curative effects were determined after laser ablation by checking with CT and CEA one month later. Results The lesions shrank in 17 cases, while 13 remained the same and enlarged in other 5 after 2-3 courses of TAE or TAI. CEA reduced in 6 cases, with no change in other 5 and increas in another 3 among the 14 positive CEA cases. CT scan showed spotty gasification in 29 cases and whole gasification in 6 after additional ablation treatment. Among them, the foci dwindled in 8 cases treated by solely laser ablation, with no change in 5 and increase in 7. The foci dwindled in 5 cases, 2 remainal the same and increase in 2 of 9 cases treated by the combination of laser ablation and percutaneous ethanol injection (PEI). Among 8 unchanged or increased CEA cases after TAE or TAI, showed decrease in 3 cases, other 4 remained the same and another increased after ablation. Conclusions 1. The blood supply of hepatic metastastic foci from coloreclal cancer is mainly fed by hepatic artery and subselective transcatheter angiography showed tumor stain clearly. 2. By means of PCS and TAI or TAE, using oxalic acid platinum, CPT11 and 5-Fu regular chemical therapy provided a better curative effect for metastasis. But 3. TAI or TAE can not eliminate all foci laser combining with ethanol ablation would be the effective complement.