Arterial chemotherapy of 5-fluorouracil and mitomycin C in the treatment of liver metastases of colorectal cancer

AIM:Regional chemotherapy using hepatic arterycatheters is a good method of treating patients withcolorectal cancer liver metastases.We investigated thesurvival of patients with liver metastases fromcolorectal cancer using 5-fluorouracil(5-FU)andmitomycin C Cthrough implantable hepatic arterialinfusion port.METHODS:Seventy-five patients with inoperable livermetastases from colorectal cancer were includedbetween March,1992 and November,2001.We placedimplantabie hepatic arterial catheter(HAC)port bylaparotomy.5-FU,1 000 mg/m~2/d continuous infusionfor five days every four weeks,was delivered in thehepatic arterial catheter through the port.MitomycinC,30 mg/m~2/d infusion in the first day every cyclethrough the port.Response to the treatment wasevaluated by serial determinations of plasma CEA andimaging techniques consisting of computerizedtomography and sonography of liver.RESULTS:Sixty-eight were performed hepatic arterychemotherapy and fifty-six were followed up amongseventy-five HAC patients.Twenty-six patients(46.4 %)have responded and 4 complete remission wereachieved.Eight patients(14.3 %)had stable livermetastases.Twenty-two patients(39.3 %)wereprogressed with increased tumor size and number.Twenty-nine patients(51.8%)had a decreased serumCEA level,while 10 patients(17.9 %)were stable and17 patients(30.4 %)had an increased serum CEA level.There were no operative death in this series.Complications,which occurred in 18 patients(32.1%),were as followed:hepatic artery thrombosis in 11,Upper gastric and intestinal bleeding in 3,liver abscessin 1,pocket infection in 1,cholangitis in 1,and hepaticartery pseudo-aneurysm in one patient.CONCLUSION:Combined infusion of 5-FU and mitomycinC by hepatic artery catheter port is an effectivetreatment for liver metastases from colorectal cancer. The high response and lower complication rates provethe adjuvant treatment of colorectal cancer with thistreatment.