Hepatic arterial 5-fluorouracil in patients with liver metastases of colorectal cancer: Single-centre experience in 145 patients

J. M G H Van Riel, C. J. Van Groeningen, S. H M Albers, M. Cazemier, S. Meijer, R. Bleichrodt, F. G. Van Den Berg, H. M. Pinedo, G. Giaccone

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1563-1570
Number of pages8
JournalAnnals of Oncology
Volume11
Issue number12
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • 5-fluorouracil
  • Arterial access device
  • Chemotherapy
  • Colorectal cancer
  • Hepatic arterial chemotherapy
  • Liver metastases
  • Port-a-cath

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Van Riel, J. M. G. H., Van Groeningen, C. J., Albers, S. H. M., Cazemier, M., Meijer, S., Bleichrodt, R., Van Den Berg, F. G., Pinedo, H. M., & Giaccone, G. (2000). Hepatic arterial 5-fluorouracil in patients with liver metastases of colorectal cancer: Single-centre experience in 145 patients. Annals of Oncology, 11(12), 1563-1570. https://doi.org/10.1023/A:1008369520179