Considerable side effects of chemoembolization for colorectal carcinoma metastatic to the liver.
The feasibility of one whole liver chemoembolization (CE) procedure with Angiostat, a vasoocclusive collagen, mitomycin, doxorubicin, and cisplatin was evaluated in eight patients with unresectable colorectal carcinoma metastatic to the liver and good performance status. One heavily pretreated patient showed a partial response in the liver lasting 188 days. Five patients had stabilization of the disease for 85-150 days. The side effects of the treatment were considerable with a fatigue syndrome lasting up to eight weeks, chemical and ischemic hepatitis, severe thrombopenia (WHO grade 4 in 2 pts) and icterus being the most disturbing toxicities. We recommend to restrict CE to patients with a life expectancy of more than 4-6 months confined to protocols, which evaluate efficacy, toxicity and influence on quality of life of CE with various cytotoxic drugs. We further suggest to perform staged unilobar CE at 4- to 6-week intervals rather than whole liver CE.
Borner
M
M
Institute of Medical Oncology, University of Bern, Inselspital Bern, Switzerland.
Castiglione
M
M
Triller
J
J
Baer
H U
HU
Soucek
M
M
Blumgart
L
L
Brunner
K
K
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D003094:Collagen / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D009325:Nausea / Q000188:drug therapy / Q000209:etiology; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010865:Pilot Projects; D010976:Platelet Count / Q000187:drug effects
D008937:Mitomycins; C075104:Angiostat; D004317:Doxorubicin; D003094:Collagen; D002945:Cisplatin