[Isolated hepatic metastases. Treatment by intra-arterial chemotherapy using a subcutaneous access chamber].
Twenty eight patients with isolated liver metastases of colorectal origin have been treated with discontinuous intra-arterial chemotherapy. This treatment was performed weekly with a surgically implanted subcutaneous access chamber. In all the patients the metastases were non-resectable and involved less than 75% of the liver. The first six patients were investigated in a phase I study which demonstrated that the method was well tolerated and provided a normal life at a lower price than the totally implanted pump. A subsequent phase II study included 22 patients. After implantation, they received an 8-hour infusion of 5 Fu 1 g/m2 each day for 8 consecutive days and after discharge, a weekly 8-hour infusion of 5 Fu 1 g/m2 and mitomycin C 1.5 mg/m2 as out-patients. Twenty-one patients have now been followed up for more than 3 months and are assessable in terms of response: we observed 4/21 complete responses, 6/21 partial responses, 3/21 minor responses, 7/21 stable disease and 1/21 progression. The objective response rate was 48%. The complication rate was low (2 leukopenias and 2 duodenal ulcerations) and comfort excellent with normal life between courses. In conclusion, with discontinuous intra-arterial chemotherapy we obtained the same response rate as with the totally implanted pump, with good tolerance and quality of life and perhaps a lower rate of complication. The two methods should now be compared in a randomized trial.
D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002408:Catheters, Indwelling; D002986:Clinical Trials as Topic; D003110:Colonic Neoplasms / Q000601:surgery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D012004:Rectal Neoplasms / Q000601:surgery
D000970:Antineoplastic Agents
Métastases hépatiques isolées. Traitement par chimiothérapie intra-artérielle par l'intermédiaire d'une chambre d'accès sous-cutanée.