Hepatic arterial infusion of oxaliplatin and L-folinic acid-modulated 5-fluorouracil for colorectal cancer liver metastases

摘要: Background: Despite the progress made in treatment of metastatic colorectal cancer (CRC), results second-line chemotherapy remain poor. Patients and Methods: The feasibility hepatic arterial infusion (HAI) oxaliplatin (100 mg/m 2 over 6 h) followed by l-folinic acid (L-FA) (400 mg h i.v.)-modulated continuous HAI 5-Fluorouracil (5-FU) (60 mg/kg 42 h; q2w) as for CRC limited to liver was investigated. Results: A median 9 cycles were administered (range 4-14). Treatment-limiting toxicity consisted of: abdominal pain (3 patients), elevated enzymes accompanied fatigue (3), bilirubin (2), neutropenia thrombocytopenia (3) hypersensitivity (1). Normalization >4 weeks carcinoembryonic antigen (CEA) level documented 3 patients a decline >50% 5 patients. confirmed partial response (PR) 5, stable disease (SD) 1 progressive (PD) In latter patients, lung metastases developed while PR observed metastases. pathological complete (CR) time progression 7.2 months (95% CI 1.3-13) overall survival 18.3 16.3-20.3). Conclusion: plus CI5-FU/LV is feasible merits further evaluation. European Union, (CRC) has an annual incidence about 372,000 cases. It second most important cause cancer-related death Western world. About half all with are cured surgery, radiotherapy adjuvant chemotherapy. Systemic considered standard disease, because it more effective than best supportive care at prolonging improving quality life. active chemotherapeutic regimens available combine topoisiomerase I inhibitor irinotecan (CPT-11) or third-generation platinum analog folinic acid-modulated administration infusional (ci5-FU/L-FA). outcome treated recently been improved addition targeted therapeutics, such anti-VEGF anti-EGFR monoclonal antibodies bevacizumab cetuximab (1-3). Metastatic only rarely curable, but resectable metastasis have 25-30% chance 5-year following hepatectomy (4, 5). CRC, who not candidates hepatectomy, 18-20 (6-9). Colorectal marked predisposition metastasize liver. At diagnosis, approximately 30% 30-40% stage IV seem be Only 10% will one anatomical amenable curative intent. Recently, small number dedicated centers provided evidence that whom become after regression under long-term comparable initially metastasis. However, majority