title: Liver metastases from colorectal cancer: regional intra-arterial treatment following failure of systemic chemotherapy.
abstract: This study was designed to determine response rate, survival and toxicity associated with combination chemotherapy delivered intra-arterially to liver in patients with hepatic metastases of colorectal origin refractory to standard systemic treatment. A total of 28 patients who failed prior systemic treatment with fluoropyrimidines received a median of 5 cycles of intra-arterial treatment consisting of 5-fluorouracil 700 mg/m(2)/d, leucovorin 120 mg/m(2)/d, and cisplatin 20 mg/m(2)/d for 5 consecutive days. Cycles were repeated at intervals of 5-6 weeks. A major response was achieved in 48% of patients: complete response in 8% and partial response in 40%. The median duration of response was 11.5 months. Median survival was 12 months at a median follow up of 12 months. On multivariate analysis, the only variables with a significant impact on survival were response to treatment and performance status. Toxicity was moderate: grades III-IV neutropenia occurred in 29% of patients. Most of the patients complained of fatigue lasting for a few days following each cycle. There were no cases of hepatobiliary toxicity. These findings indicate that regional intra-arterial treatment should be considered in selected patients with predominantly liver disease following failure of standard treatment.
authors.affiliation: Institute of Oncology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49 100, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Cyjon
authors.forename: M
authors.initials: M
authors.lastname: Neuman-Levin
authors.forename: E
authors.initials: E
authors.lastname: Rakowsky
authors.forename: F
authors.initials: F
authors.lastname: Greif
authors.forename: A
authors.initials: A
authors.lastname: Belinky
authors.forename: E
authors.initials: E
authors.lastname: Atar
authors.forename: R
authors.initials: R
authors.lastname: Hardoff
authors.forename: B
authors.initials: B
authors.lastname: Brenner
authors.forename: A
authors.initials: A
authors.lastname: Sulkes
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D015179:Colorectal Neoplasms / Q000473:pathology*; D019008:Drug Resistance, Neoplasm; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil