体内埋め込み型薬液注入装置による上顎癌動注化学療法の試み

Chemotherapy with Implantable Catheter Access

　はじめに

　既治療の上顎癌で，腫瘍の進展範囲から手術不能とされたものに対しては全身的な化学療法が第一選択となる。このような症例の予後は非常に不良であるため，希望する患者には化学療法時のみ入院し，それ以外は自宅で過ごせるような治療を行うことは，quality of life （以下QOL）を高めるうえで有意義と考える。今回初回治療の際に手術不能とされた上顎癌患老3例の前胸部に体内埋め込み型薬液注入装置（以下，薬液注入装置）を埋め込み，上甲状腺動脈を介し外頸動脈に挿入したカテーテルと接続し動注化学療法を行い，1例で目的を達成できたので報告する。

Three patients with maxillary cancer of unre-sectable stage were treated by arterial injection of anticancer drug by means of an implantable catheter access device (CA).

The CA was implanted at anterior chest and fixed on fascia of the major pectoral muscle. The catheter was inserted into the external carotid artery via the superior thyroid artery.

A 74-year-old male produced a complete remis-sion after 3 courses of chemotherapy, but died from pneumonia. Another 60-year-old male con-tinued to work as a fisherman without increasing tumor size after 4 courses of chemotherapy. It was thought that this technique was comfortable for keeping a good quality of life of patients with advanced cancer.