5-Fluorodeoxyuridine (FdUrd) was delivered into the hepatic artery by means of totally implantable devices in 61 patients with hepatic metastases from colorectal cancer. The metastatic disease was staged according to Genari's staging system. FdUrd was infused continuously for 14 days every 28 days at a dose of 0.3 mg kg-1 day-1. Hepatic resection was carried out in addition to the infusion in 12 patients. Toxic effects were observed in 24 (39%) patients; 4 of them developed biliary sclerosis. Device-related complications were reported in 37 (60%) patients; failures affected ports (86%) more frequently than pumps (32%); the median duration of pumps and ports was 28 and 9 months respectively. Among non-resected patients complete disappearance of liver metastases and normalization of carcinoembryonic antigen (CEA) were observed in 2 patients, 1 of whom died from biliary sclerosis without evident tumor. A partial remission with a median duration of 7 months was assessed in 12 additional patients; thus the objective response rate (complete plus partial) was 30% in non-resected patients; the response was not clearly related to stage, or to other prognostic factors. Of 32 patients who showed regression or stable disease, 28 had documented progression, which in 18 (64%) was initially in extrahepatic sites. The median survival was 12 months, but it differed significantly according to stage. The presence of extrahepatic disease correlated with the worst prognosis. The survival of patients treated with a pump was no different from that of patients treated with a port. The study confirms that hepatic metastases from colorectal cancer can be controlled by arterial administration of FdUrd, but the benefit of treatment to survival is still to be demonstrated. The study also suggests that features of metastatic disease into and outside the liver can significantly affect survival. Thus, in evaluating the results of different treatments, the characteristics of metastases (i.e. the extent of hepatic involvement), should be taken into account.
|Number of pages||6|
|Journal||Regional Cancer Treatment|
|Publication status||Published - 1990|
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