[Multidisciplinary treatment for liver metastasis using cytokines].
The liver is an immunologic organ with liver-associated macrophages, so-called Kupffer cells, and natural killer-like primitive T cells. These cells may play an important role in resistance to liver metastasis. T cells are activated by the T cell growth factor, interleukin-2 (IL-2). Based on the theoretical rationale, a pilot study was conducted in 20 patients with liver metastases from primary colorectal cancer who underwent potentially curative liver resection, followed by adjuvant immunochemotherapy. The regimen consisted of a weekly hepatic arterial infusion of IL-2 1.4-2.1 x 10(6) units, and 5-fluorouracil 250 mg, and a bolus of mitomycin C 2-4 mg for 6 months. Of the 20 patients, 14 are still alive with a median postoperative survival of 69.7 months (September, 2000). The 5-year overall survival rate is 78%. Although recurrent cancer developed in 6 of the 20 patients, no patients had recurrence in the residual liver. We conclude that IL-2-based immunochemotherapy is useful in combination with liver resection for the prevention of liver recurrence in colorectal cancer patients with liver metastases. A multicenter, randomized trial is recommended.
Okuno
K
K
First Department of Surgery, Kinki University School of Medicine, Osaka-sayama, Japan.
Yasutomi
M
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D016207:Cytokines / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D015996:Survival Rate
D016207:Cytokines; D007376:Interleukin-2; D016685:Mitomycin; D005472:Fluorouracil