[Hepatic arterial infusion chemotherapy for colorectal liver metastases].
Hepatic metastases are a frequent complication of colorectal cancer. Resection of liver metastases can result in long-term survival. However, the majority of patients have unresectable disease. Alternative methods in Japan for treating these patients are hepatic arterial infusion (HAI) chemotherapy with administration of 1,000 mg/m2 of 5-FU over 5 hours. We summarize the status of HAI chemotherapy in terms of colorectal hepatic metastases today. HAI chemotherapy produced higher response rates compared with systemic chemotherapy, but did not demonstrate elongation of survival time in many trials. Important problems remaining to be solved are the technical aspects of percutaneous implantation of intraarterial catheters connected to a subcutaneous infusion reservoir and studies of combined therapy with systemic chemotherapy. Furthermore, in order to finally determine the position of HAI for colorectal liver metastases, it is necessary to conduct a comparative study versus systemic chemotherapy, using the survival time as the primary end point.
Kumada
Takashi
T
Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu 503-8502, Japan.
Sone
Yasuhiro
Y
Toyoda
Hidenori
H
Kiriyama
Seiki
S
Tanikawa
Makoto
M
Hisanaga
Yasuhiro
Y
Kuzuya
Teiji
T
Nonogaki
Kouji
K
Shimizu
Juniti
J
Yamauti
Takahiro
T
Kawase
Noboru
N
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D015179:Colorectal Neoplasms / Q000473:pathology*; D004333:Drug Administration Routes; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial / Q000401:mortality*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D016685:Mitomycin / Q000008:administration & dosage; D016016:Proportional Hazards Models; D015996:Survival Rate
D000970:Antineoplastic Agents; D016685:Mitomycin; D005472:Fluorouracil