Objective To explore the clinical efficacy of transcatheter arterial chemoembolization(TACE) in the treatment of advanced colorectal carcinoma with hepatic metastases after chemotherapy. Methods 45 patients with advanced colorectal carcinoma and hepatic metastases who had received FOLFOX6 chemotherapy previously and had been assessed as tumor progression were enrolled. Fluorouracil,oxaliplatin and lipiodol were infused via hepatic artery to perform chemoembolization, and the recent efficacy, adverse reactions and 1-year survival rate were observed. Peripheral blood of patients were collected before and one week after TACK. Flow cytometry was applied to detect the T-lymphocyte subgroups in peripheral blood. Results Alanine aminotransferase (ALT) and CD4+ in peripheral blood of patients one week after TACE were higher than those before TACE(P<0. 05) , while the differences of CD3+ ,CD4+/CD8+ showed no statistical significance(P>0. 05). The common adverse reaction after TACE were mainly abdominal pain,nausea,vomiting,fever and liver function damage. There were 0 case of complete remission, 14 cases of partial remission and 21 cases of stability in 45 patients. Conclusion TACE can be served as effective second-line remedial regimen in treatment of patients with colorectal carcinoma and hepatic metastases who failed first-line chemotherapy.%目的 探讨采用经导管动脉内化疗栓塞(TACE)治疗化疗后进展期结直肠癌肝转移的临床疗效.方法 选择45例采用FOLFOX6方案化疗后疗效评估为肿瘤进展的结直肠癌肝转移患者,应用氟尿嘧啶、奥沙利铂及碘油经肝动脉灌注化疗栓塞,观察近期疗效、不良反应及1年生存率.TACE前及TACE 1周后抽取患者外周血,应用流式细胞仪检测外周血T淋巴细胞亚群.结果 TACE 1周后患者外周血丙氨酸转氨酶(ALT)、CD4+较TACE前升高(P<0.05),而CD3+、CD4+/CD8+的差异无统计学意义(P>0.05).TACE后常见的不良反应主要有腹痛、恶心、呕吐、发热及肝功能损害等.45例患者完全缓解0例,部分缓解14例,稳定21例.结论 TACE可作为治疗一线化疗失败的结直肠癌肝转移有效的二线补救方案.
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