title: Hepatic arterial infusion chemotherapy for liver metastases from gastric cancer: an analysis in Western patients.
abstract: OBJECTIVE
  The advantage of administering chemotherapy by hepatic arterial infusion is the achievement of high drug concentrations in the liver. Oxaliplatin, irinotecan and 5-flourouracil are active agents in advanced gastric cancer. Therefore a retrospective analysis was performed to investigate the effects of these drugs administered by hepatic arterial infusion in heavily pretreated gastric cancer patients with predominant hepatic metastases. Very limited data about hepatic arterial infusion exist in western gastric cancer patients.
  
  
  METHODS
  Seven patients with advanced gastric cancer were included in the retrospective analysis. All patients had proven progressive disease prior to initiation of hepatic arterial infusion. All had an ECOG performance status of < or =2 and had received at least two previous systemic chemotherapy regimens, including the combination of cisplatin/5-fluorouracil. Patients were given chemotherapy by hepatic arterial infusion: 5-fluorouracil, 600 mg/m2, together with folinic acid, 300 mg/m2/2 h, followed by oxaliplatin, 85 mg/m2/2 h, every 2 weeks.
  
  
  RESULTS
  Fifty-four cycles of hepatic arterial infusion (range, 2-21) with a median treatment duration of 6 cycles were administered in 7 patients. The treatment was feasible and safe, no grade 3-4 toxicity was observed. One patient showed stabilization of liver metastases over 7 months. In 6 of the 7 patients there was radiologically proven progressive disease after a median treatment time of 10 weeks.
  
  
  CONCLUSIONS
  Chemotherapy by hepatic arterial infusion is modestly effective in heavily pretreated gastric cancer patients. Hepatic arterial infusion has a very favorable toxicity profile and can be safely administered even in elderly patients. It might be an additional therapeutic option and should be further investigated. The literature on hepatic arterial infusion in gastric cancer patients is reviewed.
authors.affiliation: Department of Hematology Oncology and Tumorimmunology, Campus Virchow-Klinikum, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Flörcken
authors.forename: Claudia
authors.initials: C
authors.lastname: Schaefer
authors.forename: Dmitry
authors.initials: D
authors.lastname: Bichev
authors.forename: Kirstin
authors.initials: K
authors.lastname: Breithaupt
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Dogan
authors.forename: Guido
authors.initials: G
authors.lastname: Schumacher
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
authors.forename: Hanno
authors.initials: H
authors.lastname: Riess
authors.forename: Bernd
authors.initials: B
authors.lastname: Dörken
authors.forename: Peter C
authors.initials: PC
authors.lastname: Thuss-Patience
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin