Prolonged and continuous percutaneous intra-arterial hepatic infusion chemotherapy in advanced metastatic liver adenocarcinoma from colorectal primary

Abstract

Patients (60) with advanced metastatic adenocarcinoma of the liver from a colorectal primary were treated by prolonged and continuous intra-arterial hepatic arterial infusion chemotherapy from December 1969-July 1976. A 10 day course of 5-FU [5-fluorouracil] was administered in the hospital and patients were discharged receiving 5-FU by continuous arterial infusion through a chronometric infusion pump. Objective responses of 100% were obtained in 15% of patients, 50% response in 39% of patients and 25% response in 21% of patients. The median survival from onset of treatment was 8.5 mo., 6.9 mo. and 7 mo., respectively, for 100, 50 and 25% responders vs. 3.6 mo. for nonresponders. Survivals from onset of treatment were generally less in those with no disease-free interval. No relationship of response to sex and age was found. Patients previously treated with 5-FU i.v. responded to intra-arterial chemotherapy; 13% had a 100% response and 54% had a 50% response. No relationship of drug dose to response was observed. Drug toxicity was frequently systemic and mild to moderate. Numerous complications occurred due to the catheter, complete or partial thrombosis occurring in 18.6% and 20.8%, respectively, and 30% of patients had displacement of the catheter. The role of partial arterial occlusion in terms of response and survival may be significant. Future studies should involve comparison of direct surgical placement vs. percutaneous placement of catheters.