Chemotherapy for the conversion of unresectable colorectal cancer liver metastases to resection Journal Article
| Authors: | Power, D. G.; Kemeny, N. E. |
| Article Title: | Chemotherapy for the conversion of unresectable colorectal cancer liver metastases to resection |
| Abstract: | Resection of colorectal liver metastases (CLM) is the ultimate aim of treatment strategies in most patients with liver-confined metastatic colorectal cancer. Long-term survival is possible in selected patients with initially resectable or unresectable CLM. As a majority of patients have unresectable liver disease at the outset, there is a clear role for chemotherapy to downstage liver disease making resection possible. Studies of systemic chemotherapy with or without biologic therapy in patients with unresectable CLM have resulted in increased response rates, liver resection rates and survival. A sound physiologic rationale exists for the use of hepatic arterial infusion (HAI) therapy. Studies have shown that HAI with floxuridine combined with systemic chemotherapy increases response rates and liver resection rates in those patients with initially unresectable CLM. Toxicity from preoperative chemotherapy, biologic therapy and HAI therapy may adversely affect hepatic resection but can be kept minimal with appropriate monitoring. All conversion strategies should be decided by a multidisciplinary team. © 2010 Elsevier Ireland Ltd. |
| Keywords: | cancer chemotherapy; cancer survival; treatment outcome; treatment response; survival analysis; cancer surgery; fatigue; neutropenia; review; bevacizumab; fluorouracil; placebo; diarrhea; drug withdrawal; hypertension; side effect; skin toxicity; treatment duration; liver neoplasms; capecitabine; cancer patient; chemotherapy, adjuvant; chemotherapy; neurotoxicity; colorectal cancer; anemia; bone marrow suppression; bleeding; nausea; stomatitis; vomiting; antineoplastic combined chemotherapy protocols; peripheral neuropathy; camptothecin; dexamethasone; continuous infusion; cetuximab; irinotecan; panitumumab; alanine aminotransferase blood level; aspartate aminotransferase blood level; febrile neutropenia; colorectal neoplasms; wound healing; liver metastasis; folinic acid; thrombosis; infusions, intra-arterial; hepatectomy; biologic therapy; resection; alkaline phosphatase blood level; intestine perforation; biological therapy; drug substitution; oxaliplatin; floxuridine; organoplatinum compounds; leucovorin; fluoropyrimidine derivative; bilirubin blood level; vascular lesion; fatty liver; steatosis; colorectal liver metastases; hepatic arterial infusion; unresectable; conversion |
| Journal Title: | Critical Reviews in Oncology/Hematology |
| Volume: | 79 |
| Issue: | 3 |
| ISSN: | 1040-8428 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2011-09-01 |
| Start Page: | 251 |
| End Page: | 264 |
| Language: | English |
| DOI: | 10.1016/j.critrevonc.2010.08.001 |
| PROVIDER: | scopus |
| PUBMED: | 20970353 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 3 October 2011" - "CODEN: CCRHE" - "Source: Scopus" |
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