Protracted hepatic arterial infusion with low-dose cisplatin plus 5-fluorouracil for unresectable liver metastases from colorectal cancer.
BACKGROUND
Hepatic arterial infusion (HAI) chemotherapy is a treatment option for unresectable liver metastases from colorectal cancer, but it is not yet a standard treatment. The aims of this study were to demonstrate the efficacy of protracted HAI chemotherapy with low-dose cisplatin plus 5-fluorouracil for patients with unresectable liver metastases from colorectal cancer.


METHODS
Twenty-two patients with unresectable liver metastases from colorectal cancer were treated with continuous HAI of 300 mg/m2 5-fluorouracil for 5 days a week and 6 mg/m2 cisplatin for 2 hours on 5 consecutive days a week. The plasma concentrations of cisplatin and 5-fluorouracil during the treatment were measured for a pharmacokinetic study.


RESULTS
Of the 22 patients, 2 had a complete response, 13 had a partial response, 6 had stable disease, and 1 had progressive disease, and the response rate was 68% (15/22). The median survival time was 17 months, and 1-, 2-, and 3-year survival rates were 59%, 26%, and 13%, respectively. Progressive disease was the reason for treatment discontinuation in 10 (45%) of the 22 patients, and 9 (41%) patients had to stop the treatment because of complications. Systemic toxicity was minimal. The pharmacokinetic study showed a high degree of hepatic extraction for both cisplatin and 5-fluorouracil during the treatment.


CONCLUSIONS
The treatment regimen described herein thus appears to be efficacious regarding the tumor response and survival for patients with unresectable liver metastases from colorectal cancer.
Kohnoe
Shunji
S
National Kyushu Cancer Center and the Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Endo
Kazuya
K
Yamamoto
Manabu
M
Ikeda
Yasuharu
Y
Toh
Yasushi
Y
Baba
Hideo
H
Tajima
Tsuyoshi
T
Okamura
Takeshi
T
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002945:Cisplatin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil