Combining systemic chemotherapy with chemoembolization in the treatment of unresectable hepatic metastases from colorectal cancer
| Autor: | Jen-Seng Huang, Koon-Kwan Ng, Yau-Tong You, Chung-Rong Changchien |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Palliative care Colorectal cancer medicine.medical_treatment Metastasis Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Embolization Chemoembolization Therapeutic Aged Neoplasm Staging Retrospective Studies Aged 80 and over Chemotherapy business.industry Liver Neoplasms Palliative Care Gastroenterology Middle Aged Hepatology medicine.disease Combined Modality Therapy Survival Analysis Surgery Treatment Outcome Chemotherapy Adjuvant Lipiodol Female Colorectal Neoplasms business Liver cancer Follow-Up Studies medicine.drug |
| Zdroj: | International Journal of Colorectal Disease. 21:33-37 |
| ISSN: | 1432-1262 0179-1958 |
| Popis: | Treatment of liver metastases from colorectal cancer include surgical resection, radiation, hepatic chemoembolization, immunotherapy and intravenous chemotherapy. Complete surgical resection of liver metastases is feasible only for solitary or unilobar metastasis. Unresectable hepatic metastases of colorectal origin are resistant to radiation and immunotherapy, and the unsatisfactory results of systemic chemotherapy and chemoembolization have led to more aggressive treatment. A new method that combines systemic chemotherapy and chemoembolization is proposed. In this study, data from a total of 40 patients with unresectable hepatic metastasis from colorectal cancer were collected. All of these patients received combined chemoembolization and systemic chemotherapy. Embolization was performed by the selective cannulation of right and left hepatic artery. Equal amounts of a mixture of 10 ml lipiodol, 1,500 mg 5-fluorouracil (5-FU) and 15 mg leucovorin was deployed selectively in equal parts into the main right and left hepatic artery. Two weeks following chemoembolization, patients underwent systemic chemotherapy with 2,600 mg/m2 5-FU continuous infusion for 24 h and received 150 mg leucovorin intravenous bolus. The course of chemotherapy was repeated weekly for 24 weeks. The median follow-up period was 27 months (range 10-36 months). Following the intention-to-treat principle, the objective tumor response rate was 47.5%. The median disease-free interval was 12 months and the median survival time was 16 months. Most of the patients (73%) died of hepatic failure, while the second largest group died of abdominal carcinomatosis. In conclusion, the results of this study are of sufficient interest to justify future randomized trials. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink