Hepatic arterial infusion chemotherapy using fluorouracil, epirubicin, and mitomycin C for patients with liver metastases from gastric cancer after treatment failure of systemic S-1 plus cisplatin.
BACKGROUND
For patients with liver metastases from gastric cancer (LMGC), combination chemotherapy with fluoropyrimidines and platinum agents has been recognized as standard treatment. However, the prognosis of hepatic progression after first-line treatment failure remains poor. When hepatic progression occurs, hepatic arterial infusion (HAI) chemotherapy may be helpful for preventing disease progression.


OBJECTIVE
To retrospectively assess the feasibility and efficacy of HAI chemotherapy using 5-fluorouracil, epirubicin, and mitomycin C (FEM) for patients with LMGC after failure of systemic S-1 plus cisplatin.


METHODS
We reviewed the records of patients who received HAI chemotherapy using FEM for LMGC that progressed during systemic S-1 plus cisplatin treatment while extrahepatic disease was decreased or did not appear. HAI chemotherapy was given as second-line therapy using 5-fluorouracil (330 mg/m(2) weekly), epirubicin (30 or 40 mg/m(2) every 4 weeks), and mitomycin C (2.7 mg/m(2) biweekly).


RESULTS
Fourteen patients were analyzed. Toxicity of HAI chemotherapy was generally mild. The objective response rate was 42.9%, including a complete response rate of 14.3%. Median times to hepatic and extrahepatic progression were 9.2 and 7.4 months, respectively. Of 12 patients with documented progression after HAI chemotherapy, 10 patients (83.3%) received additional treatment, including irinotecan or taxanes. Overall, median survival was 12.7 months.


CONCLUSIONS
Our findings suggest that HAI chemotherapy using FEM is a feasible and effective treatment for patients with LMGC after failure of systemic S-1 plus cisplatin. HAI chemotherapy employed in the second-line setting is useful for achieving long-term disease control of LMGC.
Department of Diagnostic Radiology, Niigata Cancer Center Hospital, Niigata, Japan hseki@niigata-cc.jp.
Hiroshi
H
Seki
Department of Diagnostic Radiology, Niigata Cancer Center Hospital, Niigata, Japan.
Hiroyuki
H
Ohi
Department of Diagnostic Radiology, Niigata Cancer Center Hospital, Niigata, Japan.
Toshirou
T
Ozaki
Department of Gastroenterological Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
Hiroshi
H
Yabusaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002408:Catheters, Indwelling; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D004338:Drug Combinations; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000473:pathology*; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D015251:Epirubicin; D016685:Mitomycin; D010094:Oxonic Acid; D002945:Cisplatin; D005472:Fluorouracil
Interventional therapy; abdomen/GI; angiography; catheters; liver; metastases