Continuous intra-arterial 5-FU chemotherapy in a patient with a repeated recurrence of rectal cancer: report of a case.
OBJECTIVE
We report a patient with a recurrent pelvic tumor after abdominoperineal resection of a rectal carcinoma who was treated sufficiently by repeated intra-arterial infusions of 5-fluorouracil.


METHODS
A continuous, 24-hour 5-fluorouracil administration was made through the bilateral internal iliac artery at a dosage of 250 mg/m2/day by the subcutaneous reservoir located at both upper legs using a Baxter infusor.


RESULTS
In this patient pain in the hip and pelvis was relieved. A complete regression in the infused field of pelvic tumor was observed not only with computed tomography and magnetic resonance imaging but also confirmed by operative findings at the seventh month after the intra-arterial infusion. The abnormal serum level of carcinoembryonic antigen and carbohydrate antigen 19-9 was decreased to within the normal range at the 19th and 3rd week respectively. When the repeated recurrence was suspected in follow-up, normalization of the re-elevated carcinoembryonic antigen and carbohydrate antigen 19-9 levels was also obtained by repeating the same treatment. The side effects and complications were tolerable, consisting of local skin erosion on the hips and lower extremity neuropathy caused by the 5-fluorouracil.


CONCLUSIONS
Clinical local regression of a pelvic recurrence was observed in a patient with rectal recurrent tumor who received continuous intra-arterial chemotherapy. Local recurrence of rectal cancer may be controlled effectively and safely by repeating long-term, continuous, intra-arterial 5-fluorouracil infusion.
Toh
U
U
Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan.
Isomoto
H
H
Araki
Y
Y
Matsumoto
A
A
Yasunaga
M
M
Ogoh
Y
Y
Inuzuka
K
K
Ozaki
K
K
Shirouzu
K
K
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000627:therapeutic use; D002272:Carcinoembryonic Antigen / Q000097:blood; D005472:Fluorouracil / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010166:Palliative Care; D012004:Rectal Neoplasms / Q000188:drug therapy*
D000964:Antimetabolites, Antineoplastic; D002272:Carcinoembryonic Antigen; D005472:Fluorouracil