title: Alternating hepatic arterial infusion and systemic chemotherapy for stage IV colorectal cancer with synchronous liver metastasis.
abstract: Among 41 patients with synchronous liver metastases of colorectal cancer, 15 patients underwent synchronous resection of their liver metastases and achieved a median survival time (MST) of 1,441 days (versus 748 days for the 26 patients without resection, p=0.038), a median relapse-free survival time of 652 days (MST not reached), and a recurrence rate in the residual liver of 20% (3/15 patients). The alternating hepatic arterial infusion and systemic chemotherapy showed partial response (PR) in 6 cases, stable disease (SD) in 8 cases, and progressive disease (PD) in 1 case (n=15/26). They had an objective response rate of 40% (6/15), tumor control rate (>/= SD) of 93.3% (14/15), one-year progression-free survival rate of 35.7%, 50% time to progression of 270 days, one-year survival rate of 76.2%, and two-year survival rate of 50.8% (MST not reached). Grade 3 leucopenia was observed in 2/15 patients (13.3%). These results suggest that the present alternating therapy may become a standard regimen for patients in whom synchronous resection of liver metastases is impossible and patients who have stage IV colorectal cancer with a risk of recurrence in the remnant liver and/or at extrahepatic sites such as the lungs.
authors.affiliation: Tokai University Hachioji Hospital, Department of Surgery, Tokyo 192-0032, Japan. mukai.masaya@hachioji-hosp.tokai.ac.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Mukai
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Oida
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tajima
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kishima
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ninomiya
authors.forename: Shinkichi
authors.initials: S
authors.lastname: Sato
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hisao
authors.initials: H
authors.lastname: Nakasaki
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D008297:Male; D009362:Neoplasm Metastasis; D012008:Recurrence; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents