Hepatic arterial 5-fluorouracil in patients with liver metastases of colorectal cancer: Single-centre experience in 145 patients
| Autor: | H.M. Pinedo, Sybren L. Meijer, G. Giaccone, S. H. M. Albers, J.M.G.H. van Riel, C.J. van Groeningen, F. G. van den Berg, R. Bleichrodt, M. Cazemier |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Antimetabolites Antineoplastic medicine.medical_specialty Colorectal cancer medicine.medical_treatment Rectum mogelijke oorzaken en gevolgen (sepsis en ontsteking) [Sepsis en niet-bacteriële gegeneraliseerde ontsteking] causes and effects (sepsis and inflammation) [Sepsis and non-bacterial generalized inflammation] Gastroenterology Metastasis Hepatic Artery Internal medicine medicine Humans Infusions Intra-Arterial Aged Aged 80 and over Chemotherapy business.industry Liver Neoplasms Thrombosis Hematology Middle Aged Prognosis medicine.disease Survival Analysis Chemotherapy regimen Surgery Catheter Treatment Outcome medicine.anatomical_structure Oncology Fluorouracil Female Colorectal Neoplasms business Complication medicine.drug |
| Zdroj: | Annals of Oncology, 11, 12, pp. 1563-1570 Annals of Oncology, 11, 1563-1570 |
| ISSN: | 0923-7534 |
| DOI: | 10.1023/a:1008369520179 |
| Popis: | Background Hepatic arterial chemotherapy for liver metastases of colorectal cancer is still under discussion. Mainly because of the technical complications of this mode of treatment and the lack of a survival benefit in randomized studies. We performed an analysis of hepatic arterial 5-fluorouracil (5-FU) chemotherapy in 145 consecutive patients treated at a single institution. Patients and methods One hundred forty-five patients with inoperable liver metastases from colorectal cancer were included. 5-FU, 1000 mg/m2/day continuous infusion for five days every three weeks, was delivered in the hepatic artery by percutaneous catheter or arterial access device. Results The response rate was 34% for all patients, 40% in patients with extrahepatic disease, and 15% in patients with i.v. 5-FU-based pretreatment. TTP and OS for all patients were 7.5 and 14.3 months, respectively. In patients with extrahepatic disease or i.v. 5-FU-based pretreatment, OS was significantly shorter compared to patients without extrahepatic disease or 5-FU-based pretreatment (9.7 vs. 19.3 months and 10.1 vs. 17.4 months, respectively). forty-seven percent of patients stopped treatment because of a complication. Complications most often seen in patients with arterial ports were hepatic artery thrombosis (48%) and dislocation of the catheter (22%). Conclusions The results of our analysis are in line with previous phase III studies. Extrahepatic disease and i.v. 5-FU-based pretreatment were prognostic for reduced OS. The complication rate of hepatic arterial delivery was worrisome, although, no negative impact on survival could be established. There is a strong need for improvement of hepatic arterial delivery methods before further evaluation of hepatic arterial 5-FU will be worthwhile. |
| Databáze: | OpenAIRE |
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