Hepatic arterial chemotherapy in combination with systemic chemotherapy compared with hepatic arterial chemotherapy alone for liver metastases from colorectal cancer: Results of a multi-centric randomized study

Giammaria Fiorentini, Maurizio Cantore, Susanna Rossi, Marco Vaira, Salvatore Tumolo, Patrizia Dentico, Andrea Mambrini, Paolo Bernardeschi, Gina Turrisi, Petros Giovanis, Stefano Guadagni, Vanna Valori, Michele De Simone

Research output: Contribution to journalArticle

Abstract

Hepatic arterial infusion (HAI) chemotherapy is accepted to be an option in patients with non-resectable metastases from colorectal cancer confined to the liver. In a multi-istitutional trial, 76 patients were randomly assigned to receive HAI versus HAI plus systemic bolus 5-fluorouracil and leucovorin. The primary end-point was survival followed by response, recurrence and toxicity. Survival was longer for HAI plus systemic chemotherapy (HAI+SYC) than HAI (median, 20 vs. 14 months; p=0.0033), as were responses (47.5% and 41.7%; p=0.09) and time to hepatic progression (12 vs. 8 months; p=0.039). Side effects included haematological toxicity that was mostly mild and reversible in 432 cases. Neutropenia grade 3 occurred in four patients in the HAI+SYC arm and one in the HAI arm. Diarrhoea occurred in 20% and 7% of patients and stomatitis occurred in 18% and 2%, respectively. On the contrary biliary toxicity was significant; twelve patients had evidence of bilirubin elevations of more than 3 mg/dl (six in each arm), and two had asymptomatic arterial biliary-tree fistulae: one in the HAI+SYC arm and one in the HAI arm. Grade 3 elevation in alkaline phosphatase and aminotransferase levels occurred in 26% and 24%, respectively. In conclusion, the combination of HAI+SYC is active and safe showing a clinical advantage with respect to simple HAI, increasing overall survival response rate and time to progression.

Original languageEnglish
Pages (from-to)707-710
Number of pages4
JournalIn Vivo
Volume20
Issue number6 A
Publication statusPublished - Nov 2006

Keywords

  • Colorectal cancer
  • Intra-arterial hepatic chemotherapy
  • Liver metastases

ASJC Scopus subject areas

  • Medicine(all)

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    Fiorentini, G., Cantore, M., Rossi, S., Vaira, M., Tumolo, S., Dentico, P., Mambrini, A., Bernardeschi, P., Turrisi, G., Giovanis, P., Guadagni, S., Valori, V., & De Simone, M. (2006). Hepatic arterial chemotherapy in combination with systemic chemotherapy compared with hepatic arterial chemotherapy alone for liver metastases from colorectal cancer: Results of a multi-centric randomized study. In Vivo, 20(6 A), 707-710.