[Results of intra-arterial infusion chemotherapy of colorectal cancer in patients with metastatic liver cancer].
Fifty-nine colorectal cancer patients with metastatic liver cancer who underwent intra-arterial infusion chemotherapy (IAIC) at the National Cancer Center Hospital from May 1986 to February 1989 were reviewed. Excisions of metastatic liver cancer were performed in 36 patients and 23 had nonresectable metastatic liver cancer. Catheter troubles, including severe infection (8), extravasations (3), obstruction (1) and other problems (1) occurred in 13 (22.0%) patients, and 6 patients (10.2%) were unable to receive IAIC. Three patients did not undergo IAIC because of hepatitis or other reasons. Serious complications following IAIC, including sclerosing cholangitis (6), extravasations (6) and obstructions (3) were observed in 15 patients (30.0%). Results of IAIC were discussed in 21 patients undergoing hepatic resection and 17 patients with nonresectable metastatic liver cancer. 5-Fluorouracil (5-FU) (700 mg/m2) and mitomycin C (MMC) (7 mg/m2) were infused through implantable pumps every week or every two weeks. Total infused doses of 5-FU ranged from 500 to 15,000 mg (mean: 8,300 +/- 3,400 mg) and those of MMC were from 26 to 144 mg (mean: 58.8 +/- 32.7 mg) in 21 patients undergoing hepatic resections, whereas 1,500-26,250 mg (mean: 11,000 +/- 7,800 mg) of 5-FU and 0-130 mg of MMC (mean: 57.3 +/- 33.3) were infused in 17 patients with nonresectable liver cancer. Seven patients (33.3%) had recurrent liver cancer during 7-31 months (mean: 16.2 +/- 6.0 m) follow-up after hepatic resections, whilst only 3 of 13 patients (23.1%) with solitary liver metastasis had recurrent liver cancer. Three of these recurrent liver cancer patients (37.5%) underwent hepatic re-excision. Seven of 17 nonresectable patients (41.2%) were responders. Three patients completely responded (CR) and 4 responded partially (PR). Another study is needed to clarify the effect of IAIC in survival. IAIC should be undertaken as a treatment not only for patients with nonresectable metastatic liver cancer, but also for those with resectable metastatic liver cancer in order to prevent hepatic recurrence.
Sawada
T
T
Dept. of Colorectal Surgery, National Cancer Center Hospital.
Hojo
K
K
Moriya
Y
Y
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D002404:Catheterization / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects; D007261:Infusions, Intra-Arterial / Q000009:adverse effects / Q000379:methods; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000601:surgery; D012074:Remission Induction
D008937:Mitomycins; D016685:Mitomycin; D005472:Fluorouracil