5-FU or mitomycin C hepatic arterial infusion after failure of arterial oxaliplatin in patients with colorectal cancer unresectable liver metastases
| Autor: | Marc Sapoval, Rapahel Hampig Kourie, Bruno Landi, Gregory Amouyal, Anne-Laure Pointet, Olivier Pellerin, Céline Lepère, Julien Taieb, Yosra Zaimi, Simon Pernot, Guillaume Velut |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty animal structures Colorectal cancer Mitomycin medicine.medical_treatment Antineoplastic Agents Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences Hepatic Artery 0302 clinical medicine Hepatic arterial infusion Internal medicine medicine Humans Infusions Intra-Arterial In patient Treatment Failure Aged Retrospective Studies Aged 80 and over Chemotherapy Hepatology business.industry Liver Neoplasms Mitomycin C virus diseases Middle Aged medicine.disease Oxaliplatin 030220 oncology & carcinogenesis Concomitant Toxicity Female Fluorouracil Colorectal Neoplasms business medicine.drug |
| Zdroj: | Clinics and Research in Hepatology and Gastroenterology. 42:255-260 |
| ISSN: | 2210-7401 |
| DOI: | 10.1016/j.clinre.2017.11.004 |
| Popis: | Summary Introduction Hepatic arterial infusion (HAI) chemotherapy with oxaliplatin is an accepted option in the management of colorectal cancer (CRC) with dominant liver metastases (LM). However, despite prolonged control, some patients experience disease progression. On the other hand, oxaliplatin leads to dose-limiting toxicity. In these cases, the use of a second-line HAI with an alternative drug has never been reported to date. We evaluated treatment outcomes in patients receiving second-line HAI with 5-FU or mitomycin C, after first-line HAI of oxaliplatin in heavily pretreated patients. Material and methods Between March 2010 and June 2016, this observational study included 24 patients with unresectable CRC LM and treated with HAI of 5-FU (17 patients) or mitomycin C (7 patients), after HAI of oxaliplatin. Results Mean age was 61.7 years. Forty-two percent of patients (10/24) had extra-hepatic metastases and 75% (18/24) at least 8 liver metastases. Including HAI of oxaliplatin, all patients had previously received at least 2 lines of chemotherapy ± targeted agents (100%) and 96% (23/24) received concomitant systemic therapies together with HAI of 5-FU or mitomycin C. The overall objective response rate and disease control rate were, respectively, 42% (10/24) and 71% (17/24). Median progression-free survival and overall survival (OS) were, respectively, 5.6 and 25.8 months; hepatic progression-free survival was 8.5 months. Thirteen percent (3/24) of the patients received further curative intent treatment after HAI 5-FU and mitomycin C. No toxic death occurred and the toxicity profile was acceptable. Conclusions HAI of 5-FU or mitomycin C is an alternative option in patients with predominant CRC LM, when they experience disease progression or do not tolerate HAI of oxaliplatin. |
| Databáze: | OpenAIRE |
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