2023年6月21日

2023年6月21日,在夥伴關係:醫生在cedars - sinai癌症化療使用一個獨特的交付係統,提供希望結直腸癌病人的疾病傳播,世衛組織現在已經不實用的肝髒腫瘤。克裏斯蒂娜Ferrone博士醫生在cedars - sinai癌症化療使用一個獨特的交付係統,提供希望結直腸癌病人的疾病傳播,世衛組織現在已經不實用的肝髒腫瘤。西奈是為數不多的提供治療中心的區域,稱為肝動脈灌注化療(HAI)泵。“許多患者不適合手術治療,我們現在有一個有意義的選擇治療他們,“克裏斯蒂娜Ferrone說,醫學博士,外科學係的主席在cedars - sinai專家和患者的護理複雜hepato-pancreato-biliary紊亂。“這個療法已被證明延長生命和生活質量。“結直腸癌是至今在美國癌症相關死因多達25%的患者被診斷出患有這種疾病,癌症擴散到肝髒,很難治療。然而,超過一半的患者接受肝動脈灌注泵治療繼續接受手術治療,研究顯示。外科腫瘤學家亞曆山德拉Gangi醫學博士,胃腸道腫瘤項目主任副教授在cedars - sinai癌症,手術在cedars - sinai,坐下來與西奈編輯部來解釋這個拯救生命的治療。泵的工作怎麼樣?我們手術皮下泵,腹腔外,它與油管進入腹腔,進入胃十二指腸動脈。 That artery feeds into the hepatic artery, which supplies blood to the liver. During surgery, we block blood flow from the gastroduodenal artery from going into portions of the small intestine so that the therapy flows only to the liver. The pump has a soft center, allowing its internal reservoir to be filled through the skin via a syringe. After surgery, the patient comes in every two weeks and we refill the pump, which then allows the chemotherapy drug to flow directly into the liver via the arterial supply. Which patients are likely to benefit from hepatic artery infusion pump therapy? This therapy is designed for patients, based on the distribution of the metastatic disease (where are the tumors and how many), for whom curative surgery is not an option at the time of diagnosis. The best we had been able to offer these patients was lifelong chemotherapy that had potential systemic toxicities, and that never quite reduced their tumor size to the point that we could surgically remove it. This therapy offers an additional option for liver-directed therapy that can potentially make patients candidates for surgery by specifically targeting the liver disease. What are the advantages of the hepatic artery infusion pump over traditional chemotherapy delivery? A majority of these tumors derive their blood supply from the hepatic arterial system, and delivering chemotherapy to the tumors through the hepatic arterial system allows us to give higher doses of specific chemotherapeutic agents without exposing the patient to their systemic toxicities. Data shows that up to 60% of appropriately selected patients receiving hepatic artery infusion pump chemotherapy were then able to receive curative surgery. Patients can often continue receiving systemic chemotherapy in combination with hepatic artery infusion pump chemotherapy. Are hepatic artery infusion pumps used to treat other types of liver cancer? Some patients with cholangiocarcinoma are currently treated with HAI pumps, but this is not yet standard of care. Colon cancer is the second most common cancer, and colon cancer that has metastasized to the liver affects a significant number of patients. And we have seen good outcomes with those patients. Other types of cancers that metastasize to the liver are significantly more challenging to treat, and thus far, we don't think this therapy will benefit those patients. Is this a new therapy? Hepatic artery infusion pumps have actually been around for about 25 to 30 years, but until quite recently only a few medical centers were using them. But more and more centers are realizing that this therapy can truly benefit patients, and it is becoming more widely available. Related Videos