Hepatic metastases are a major cause of death in patients with colorectal carcinoma. Traditional intravenous chemotherapy produces resposes in 10% to 30% of patients and surgical resection is feasible in approximately 20% of patients. Infusion of cytotoxic agents into the hepatic artery is the most promising form of therapy for unresectable hepatic metastases. The recent development of a totally implantable pump has allowed prolonged infusion of chemothera-peutic agents with a good compliance and quality of life of the patients. The rationale for hepatic arterial infusion (HAI) present an anatomical and pharmacological basis with the use of agents with high hepatic extraction risul-ting in minimal systemic toxicity. The results of eight randomized trial assessing the value of HAI Floxuridine shows that such regional chemotherapy increases the likelihood of hepatic response compared with systemic treatment (52% vs 15%). Survival information is difficult to evaluate because some of the studies are small, some had a crossover design and some others had bias factors. Extrahepaiic disease develops in 40-70 % of patients undergoing HAI; the use of systemic therapy plus HAI may produce a decrease in extrahepatic desease. Further studies of combined systemic/arterial regiment are necessary.
|Translated title of the contribution||Locoregional chemotherapy in liver metastases from colorectal cancer|
|Number of pages||5|
|Journal||Annali Italiani di Chirurgia|
|Publication status||Published - Nov 1996|
ASJC Scopus subject areas