Hepatic arterial infusion (HAI) of cisplatin and systemic fluorouracil in the treatment of unresectable colorectal liver metastases.
BACKGROUND
Only 5-10% of colorectal cancer patients (pts) with liver metastases are eligible for surgical resection. Regional and systemic chemotherapy represents the best therapeutic options for unresectable metastases.


METHODS
In a randomized phase II trial 123 pts were enrolled with a minimum follow-up of 3 years. In Arm A 58 pts were submitted to intraarterial continuous infusion of cisplatin (CDDP), 24 mg/m2/day, while the other 65 were included in Arm B (bolus of CDDP, 24 mg/m2/day). All the pts were also given i.v. escalating doses of fluorouracil. Response was evaluated after a minimum of 3 cycles.


RESULTS
Toxicity > or = G3 was lower in Arm B. The objective response rate was 52% in all the series, the complete responses being 17.3% (17.6% vs. 17% in Arms A and B, respectively). The overall median survival was 18 months rising to 28 months in the responders.


CONCLUSIONS
CDDP HAI provided similar results as FUdR in terms of response to treatment. Moreover, long-term survivors were unexpectedly observed.
Mancini
Raffaello
R
Department of Surgical Oncology, Regina Elena Cancer Institute, Via Elio Chianesi, 53, 00013 Rome, Italy.
Tedesco
Manfredo
M
Garufi
Carlo
C
Filippini
Angelo
A
Arcieri
Stefano
S
Caterino
Mauro
M
Pizzi
Giuseppe
G
Cortesi
Enrico
E
Spila
Antonella
A
Sperduti
Isabella
I
Cosimelli
Maurizio
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002404:Catheterization; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery
D002945:Cisplatin; D005472:Fluorouracil