title: Hepatic arterial continuous infusion (HACI) of oxaliplatin in patients with unresectable liver metastases from colorectal cancer.
abstract: BACKGROUND
  Oxaliplatin, a new DACH-platinum compound, has provided high response rates both in untreated and 5-FU-resistant patients.
  
  
  OBJECTIVE
  To define the feasibility and toxicity profile of Oxaliplatin administered as a continuous hepatic aterial infusion.
  
  
  METHODS
  Seventeen patients with pretreated metastatic liver colorectal cancer were treated with Oxaliplatin 20 mg/m2/day by HACI x 5 days every 3 weeks.
  
  
  RESULTS
  Toxicity grade 3 included pain (4 out of 17), asthenia (1 out of 17) and nausea (1 out of 17). Abdominal pain grade 4 (WHO) was noted in only one patient. Overall, severe abdominal pain (main dose-limiting toxicity) was observed in 41% of patients and no chemical hepatitis and sclerosing cholangitis pain-related was proven by an endoscopic retrograde cholangiography. The response rate was not a primary end-point; nonetheless among 15 evaluable patients we observed partial responses (PR) in 7 patients (46%) and stable disease (SD) in 21% of cases for an overall tumor growth control of 67%. Progression to disease (PD) was 33%. Following chemotherapy, one patient underwent surgical removal of residual metastases, with curative intent. The 1-year survival rate was 64%. The median duration of survival was 19 months. The median delay to hepatic progression was 10 months.
  
  
  CONCLUSIONS
  Further studies are required to define the role of HACI Oxaliplatin, the schedule of administration (bolus vs continuous infusion) and the combination, also in this setting, with fluoropyrimidines.
authors.affiliation: Department of Experimental Medicine and Pathology, University of Rome La Sapienza, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mancuso
authors.forename: Rosa
authors.initials: R
authors.lastname: Giuliani
authors.forename: Caterina
authors.initials: C
authors.lastname: Accettura
authors.forename: Marzia
authors.initials: M
authors.lastname: Palma
authors.forename: Giuliana
authors.initials: G
authors.lastname: D'Auria
authors.forename: Fabiana
authors.initials: F
authors.lastname: Cecere
authors.forename: Luca
authors.initials: L
authors.lastname: Paoluzzi
authors.forename: Mario
authors.initials: M
authors.lastname: Bezzi
authors.forename: Bruno
authors.initials: B
authors.lastname: Massidda
authors.forename: Enrico
authors.initials: E
authors.lastname: Cortesi
mesh_terms: D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage* / Q000009:adverse effects*; D000077150:Oxaliplatin
chemical_list: D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin