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Japanese Journal of Clinical Oncology 33:132-135 (2003)
© 2003 Foundation for Promotion of Cancer Research

Weekly Hepatic Arterial Infusion of 5-Fluorouracil and Subsequent Systemic Chemotherapy for Liver Metastases from Colorectal Cancer

Ayumu Hosokawa1, Yasuhide Yamada1, Yasuhiro Shimada1, Kei Muro1, Yasuhiro Matsumura1, Shin Fujita2, Takayuki Akasu2, Yoshihiro Moriya2,+ and Kuniaki Shirao1

1 Gastrointestinal Oncology Division and 2 Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan

Objective: To determine the antitumor activity and toxicity of weekly hepatic arterial infusion (HAI) of 5-fluorouracil (5-FU) for liver metastases from colorectal cancer. In addition, the present study also evaluated the efficacy of second-line chemotherapy after termination of HAI.

Methods: A retrospective study was designed to evaluate the clinical outcome in patients treated with HAI. Twenty-six patients with liver metastases from colorectal cancer were treated with 5-FU 1000 mg/m2 over 5 h once per week on an outpatient basis. The treatment was continued until disease progression, unacceptable toxicity or the patient’s refusal to continue treatment occurred. One of three kinds of second-line systemic chemotherapy, irinotecan alone, protracted venous infusion of 5-FU or methotrexate (MTX) and 5-FU, was chosen after termination of HAI.

Results: An objective tumor response to HAI was observed in 46% (95% confidence interval, 26.9–65.2%) of 26 patients. The most common adverse events were mild nausea and vomiting (35%) and occurrence of gastroduodenal ulcers (15%). Hematological toxicity was minimal. No responder was observed to improve following second-line chemotherapy after termination of HAI.

Conclusion: Weekly HAI of 5-FU is both active and well tolerated. However, extrahepatic progression was observed in one-third of patients with termination of HAI and the efficacy of second-line chemotherapy was not demonstrated. Regional treatment with systemic chemotherapy should be conducted to achieve good results in terms of survival.

+ For reprints and all correspondence: Yasuhide Yamada, Gastrointestinal Oncology Division, National Cancer Center Hospital, 5–1–1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. E-mail: yayamada{at}ncc.go.jp


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