Patterns of serum CEA fall after hepatic arterial chemotherapy as sole therapy and combined with cryotherapy for colorectal metastases.
BACKGROUND
Hepatic artery chemotherapy (HAC) and cryoablation are treatments for unresectable liver metastases from colorectal carcinomas. Our centre has previously published data that describe survival statistics of patients after each of these treatments. It has also been established that serial serum carcinoembryonic antigen (CEA) concentrations may be used to monitor disease progress, and that the magnitude of fall is prognostic for both treatments. The pattern of fall of CEA following cryotherapy and regional chemotherapy has not previously been compared.


METHODS
In this study, we examined 26 HAC patients and 24 cryotherapy patients.


RESULTS
The mean percentage of the pre-treatment CEA concentration for the HAC group was 60.5% at 50 days and 29.4% at 150 days, and for the cryotherapy group 24.9% at 50 days and 24.3% at 150 days. Calculating the difference between means revealed a significantly different mean fall in the cryotherapy group at 50 days (P < 0.001) and a difference in mean fall at 150 days (P > 0.1) which was not significant. In patients who responded to hepatic artery chemotherapy, the eventual CEA fall was very similar in magnitude.


CONCLUSIONS
The pattern of fall of CEA differs in these two treatments.
University of New South Wales, Department of Surgery, St George Hospital, Sydney, Australia.
R A
RA
Hocking
D L
DL
Morris
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D017679:Cryotherapy; D005472:Fluorouracil / Q000008:administration & dosage*; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*
D000964:Antimetabolites, Antineoplastic; D002272:Carcinoembryonic Antigen; D005472:Fluorouracil