Korean J Intern Med.  2011 Mar;26(1):82-88. 10.3904/kjim.2011.26.1.82.

Efficacy and Safety of Hepatic Arterial Infusion of Fluorouracil with Leucovorin as Salvage Treatment for Refractory Liver Metastases from Colorectal Cancer

• Lee HJ
• Lee YS
• Lee KW
• Kim SY
• Yoon CJ
• Shin DY
• Lee YG
• Choi SY
• Kang SG
• Kang SB
• Kim JH

• KMID: 1036155
• DOI: http://doi.org/10.3904/kjim.2011.26.1.82

Abstract

BACKGROUND/AIMS
Limited options remain for patients with metastatic colorectal cancer (CRC) after failure of standard systemic chemotherapy. Readministration of chemotherapeutic agents by hepatic arterial infusion (HAI) has the rationale of providing higher concentrations of chemotherapeutic agents to hepatic metastases. The present study was conducted to evaluate the efficacy and safety of HAI of fluorouracil with leucovorin (HAI 5-FU/LV) for patients with liver metastases from CRC.
METHODS
Fourteen patients with liver metastases from CRC who received HAI 5-FU/LV after failure of systemic chemotherapy containing fluorouracil and leucovorin were identified and their medical records were reviewed.
RESULTS
Of 10 patients evaluable for response, one partial response, six stable disease, and three progressive disease were reported. Additionally, the overall response and disease control rates were 7% and 50%, respectively. The median time to progression was 4.3 months (range, 2.9 to 5.6), to hepatic progression was 5.8 months (range, 4.7 to 6.9), and to extrahepatic progression was 5.8 months (range, 2.3 to 9.2). No grade 3/4 hematologic toxicities occurred and one case of abdominal pain and two cases of oral mucositis were the only grade 3 nonhematologic toxicities. Catheter-related complications occurred in three patients: one thrombosis, one infection, and one displacement.
CONCLUSIONS
HAI 5-FU/LV was well tolerated and showed modest efficacy for patients with liver metastases from refractory CRC. Readministration of previously used chemotherapeutic agents via the hepatic artery could be an effective salvage option and warrants further investigation in a prospective trial.

Keyword

Colorectal neoplasms; Fluorouracil; Infusions, intra-arterial; Leucovorin

MeSH Terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse effects
Colorectal Neoplasms/*pathology
Female
Fluorouracil/administration & dosage/*therapeutic use
Humans
*Infusions, Intra-Arterial
Leucovorin/administration & dosage/*therapeutic use
Liver Neoplasms/*drug therapy/mortality/*secondary
Male
Middle Aged
*Salvage Therapy