Hepatic Intraarterial Chemotherapy in Unresectable Hepatic Metastases of Colorectal Cancer

Kim, Jin Cheon; Lee, Han Il; Yu, Chang Sik; Chung, Hee Won; Kim, Sang Wee; Lee, Jeong Sin; Park, Kun Choon

Abstract

PURPOSE: Unresectable hepatic metastases of colorectal cancer does not seem to be amenable to the various treatment modalities. We modified hepatic intraarterial chemotherapy by different installation of port and regimen.
MATERIALS AND METHODS
Between July 1989 to December 1995, 27 patients of colorectal cancer with unresectable liver metastases were randomly allocated into either hepatic intraarterial (HA, 11 patients) or systemic intravenous (IV, 16 patients) chemotherapy after primary tumor resection. Chemo-port was installed with preservation of hepatic arterial flow. One cycle of HA regimen included 5-fluorouracil (5-FU) and mitomycin-C (MMC) with or without leucovorin (LV) for 14 days every month. The IV regimen included 5-FU and LV for 5 days every month. Both HA and IV chemotherapy were continued from 6 to 12 cycles.
RESULTS
The response exceeding partial remission was experienced in six patients (55%) among 11 patients in the HA group, while only two (13%) patients showed response among sixteen patients in the IV group. One year survival was not different between two groups. Although lethal toxicity was not found, patients showed marked increase of the performance scale (ECOG) in both groups.
CONCLUSION
Although survival benefit was not prominent, higher response rate with tolerable complication was found in the HA group. Prudent selection of effective drugs and combination of systemic chemotherapy are needed to improve the survival with minimal complication.