Intrahepatic or Systemic Infusion of Fluorodeoxyuridine in Patients with Liver Metastases from Colorectal Carcinoma

摘要: OBJECTIVE To compare the efficacy of direct hepatic arterial chemotherapy with systemic in patients liver metastases from colorectal carcinoma. DESIGN Randomized trial crossover allowed to intrahepatic therapy if tumor progression occurred on therapy. SETTING Academic medical center, referral-based clinic. PATIENTS One hundred sixty-two carcinoma agreed be randomly assigned treatment groups. At laparotomy, 63 were excluded study: 25 had resection; 33, extrahepatic disease; 1, infection; and 4, no tumor. INTERVENTION Fourteen-day continuous infusion fluorodeoxyuridine each month using an infusaid pump (0.3 0.15 mg/kg body weight X d arms, respectively). MAIN RESULTS Intrahepatic produced a significantly higher complete partial response rate, 50%, compared 20% for (p = 0.001). After progression, 60% crossed over therapy; 25% then response, 33% minor or stabilization disease Toxicity included ulcer (17%) biliary sclerosis (8%) receiving diarrhea (70%) Extrahepatic 56% 37% groups, respectively 0.092). The median survivals 17 12 months, respectively. CONCLUSION When therapy, increases rate appears more effective treatment.