[Long-term control of rectal liver metastases by hepatic arterial infusion chemotherapy of 5-fluorouracil and l-leucovorin--a case report].
For synchronous liver metastases from rectal cancer, after extirpation of the primary lesion, a transcatheter arterial embolization was postoperatively performed 3 times at 6-month intervals. Metastatic lesions in S1 and S8 resulted in progressive disease at 8 and 13 months postoperatively, and simultaneous sharp elevation of both CEA and CA19-9 levels. Therapy was then changed to hepatic arterial infusion (HAI) chemotherapy combined with 5-fluorouracil and l-leucovorin (17 months postoperatively). S1 and S8 demonstrated CR and PR, respectively, 8 months after initiation of HAI. Correspondingly, both CEA and CA19-9 levels decreased dramatically, and have thereafter remained stable to date without marked elevation 36 months after the start of HAI. These findings suggest that our regimen for HAI chemotherapy may effectively control liver metastases and restrain progression over the long-term, that is, establish "tumor dormancy" as proposed in recent years. Moreover, CEA and CA19-9 played important roles as surrogate markers that reflect the response to metastatic tumors.
Kanayama
Teruji
T
Dept of Surgery, Sekitetsukai Tanabe Central Hospital.
Ishimaru
Sumiko
S
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery
D002955:Leucovorin; D005472:Fluorouracil