Regional Infusion Chemotherapy for Colorectal Hepatic Metastases
Large bowel cancer is the second most common malignancy with the liver being the predominate site of distant metastases. Prospective studies evaluating the natural history of advanced disease suggest a median survival of five to six months, however, there is a wide range depending upon the extent of hepatic involvement. Disappointment with systemic chemotherapy has led to increased investigations regarding regional therapy directed at the liver. In the past, improved response rates have been noted with hepatic arterial infusion chemotherapy, however, complications of the technique have not led to widespread acceptance. Use of an implantable pump has decreased technical and infectious complications associated with this method of treatment. A phase II trial at Memorial Sloan Kettering Cancer Center showed that previously untreated patients had a response rate of 50% while in previously treated patients the response rate was 31%. Toxicity involved the gastrointestinal tract with chemical hepatitis and gastritis being the predominate manifestations. Further, prospective clinical trials of intraarterial chemotherapy for colorectal hepatic metastases are indicated to provide definitive conclusions regarding tumor response rates, length of patient survival, cost, morbidity, and quality of life during treatment.
KeywordsHepatic Artery Hepatic Metastasis Gastroduodenal Artery Tumor Response Rate Hepatic Arterial Infusion Chemotherapy
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