[Implanted percutaneous continuous hepatic arterial infusion system for nonresectable liver metastasis].
OBJECTIVE
To evaluate the efficacy of continuous hepatic arterial infusion of 5-fluorouracil (5-Fu)/calcium folinate (CF) through an implanted percutaneous arterial infusion system for nonresectable liver metastasis.


METHODS
Sixty-eight patients with nonresectable liver metastasis received continuous hepatic arterial infusion of 5-Fu 500 mg/m2.d, CF 100 mg/m2.d and dexamethasone 10 mg/d1-5 via a drug delivery system (DDS) implanted percutaneously with the catheter introduced via the femoral artery or left subclavian artery for 5 days, once every month in combination with cisplatin and/or mitomycin-C, epirubicin and cytoxan as a multi-drug protocol.


RESULTS
The overall response rate (CR + PR) was 47.1% (32/68), with 2 patients giving CR and 30 PR. The response seemed to correlate with the intrahepatic tumor burden as 60.6% response rate was observed in intrahepatic tumor burden of less than 25% versus 34.3% response rate in those with more than 25% (P < 0.05). The median survival period was 15.2 months. The 1-, 2-year survival rates were 61.1% and 35.2% respectively in 54 patients who were followed. The therapeutic result was better in patients with liver metastasis originating from the gastrointestinal tract carcinoma than those from non-gastrointestinal tract carcinoma (P < 0.05). In patients with liver metastasis originating from the gastrointestinal tract carcinoma, the median survival was 17.6 months, with 1-, 2-year survival rates of 68.4% and 39.5%. There was no severe toxic side effects or complications. The toxic reaction in liver, biliary and gastrointestinal tract was mild.


CONCLUSIONS
Continuous hepatic arterial infusion of 5-Fu/CF and dexamethasone via a subcutaneous drug delivery system is able to prolong the survival and improve the quality of life in patients with nonresectable liver metastasis.
Zhu
K
K
Department of Radiology, Third Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou 510630, China.
Shan
H
H
Li
Z
Z
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000503:physiopathology
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil