Protracted hepatic arterial infusion with low-dose cisplatin plus 5-fluorouracil for unresectable liver metastases from colorectal cancer.

Journal: Surgery
Published:
Abstract

Background: Hepatic arterial infusion (HAI) chemotherapy is a treatment option for unresectable liver metastases from colorectal cancer, but it is not yet a standard treatment. The aims of this study were to demonstrate the efficacy of protracted HAI chemotherapy with low-dose cisplatin plus 5-fluorouracil for patients with unresectable liver metastases from colorectal cancer.

Methods: Twenty-two patients with unresectable liver metastases from colorectal cancer were treated with continuous HAI of 300 mg/m2 5-fluorouracil for 5 days a week and 6 mg/m2 cisplatin for 2 hours on 5 consecutive days a week. The plasma concentrations of cisplatin and 5-fluorouracil during the treatment were measured for a pharmacokinetic study.

Results: Of the 22 patients, 2 had a complete response, 13 had a partial response, 6 had stable disease, and 1 had progressive disease, and the response rate was 68% (15/22). The median survival time was 17 months, and 1-, 2-, and 3-year survival rates were 59%, 26%, and 13%, respectively. Progressive disease was the reason for treatment discontinuation in 10 (45%) of the 22 patients, and 9 (41%) patients had to stop the treatment because of complications. Systemic toxicity was minimal. The pharmacokinetic study showed a high degree of hepatic extraction for both cisplatin and 5-fluorouracil during the treatment.

Conclusions: The treatment regimen described herein thus appears to be efficacious regarding the tumor response and survival for patients with unresectable liver metastases from colorectal cancer.

Authors
Shunji Kohnoe, Kazuya Endo, Manabu Yamamoto, Yasuharu Ikeda, Yasushi Toh, Hideo Baba, Tsuyoshi Tajima, Takeshi Okamura
Relevant Conditions

Liver Cancer, Colorectal Cancer