Regional chemotherapy for liver-limited metastatic colorectal cancer Journal Article
| Authors: | Power, D. G.; Healey-Bird, B. R.; Kemeny, N. E. |
| Article Title: | Regional chemotherapy for liver-limited metastatic colorectal cancer |
| Abstract: | This review examines the development of hepatic arterial infusion (HAI) of chemotherapy over the past 40 years. Liver metastases are mainly supplied by the hepatic artery, and high levels of intratumoral drug delivery are achievable with the use of HAI. Floxuridine, 5-fluorodeoxyuridine is commonly used, but intra-arterial oxaliplatin and mitomycin-C also have advantages.The dramatic responses observed with HAI plus systemic therapy offer the possibility of resection and cure in select patients. Resectability of liver-limited colorectal cancer metastases should be considered as an endpoint for all patients. Hepatic arterial infusion may be used in palliative, neoadjuvant, and adjuvant settings. Herein, combinations of systemic chemotherapy with HAI are discussed, along with the role of newer cytotoxic and biologic agents. The first-pass extraction of some drugs given by regional perfusion in the liver limits systemic side effects. Toxicity includes catheter-related complications and biliary and gastrointestinal ulcers. The role of HAI therapy for the treatment of unresectable and resectable disease, as well as the use of other regional strategies such as embolization and ablation, are discussed. |
| Keywords: | treatment response; neutropenia; review; cisplatin; doxorubicin; fluorouracil; artificial embolism; cancer combination chemotherapy; diarrhea; side effect; systemic therapy; liver neoplasms; gemcitabine; cancer adjuvant therapy; cancer patient; chemotherapy, adjuvant; neoadjuvant therapy; cancer palliative therapy; colorectal cancer; interleukin 2; multiple cycle treatment; bone marrow suppression; stomatitis; antineoplastic combined chemotherapy protocols; camptothecin; dexamethasone; cetuximab; irinotecan; abdominal pain; colorectal neoplasms; health care cost; liver metastasis; digestive system ulcer; folinic acid; drug infusion; infusions, intra-arterial; liver resection; mitomycin c; mitomycin; oxaliplatin; hematoma; floxuridine; organoplatinum compounds; nv 1020; leucovorin; artery thrombosis; drug delivery system; catheter ablation; hepatic artery; hepatic arterial infusion; liver perfusion; pirarubicin; 5-fluoropyrimidines; catheter blockage; bile acid blood level; first pass effect; injection site infection |
| Journal Title: | Clinical Colorectal Cancer |
| Volume: | 7 |
| Issue: | 4 |
| ISSN: | 1533-0028 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-07-01 |
| Start Page: | 247 |
| End Page: | 259 |
| Language: | English |
| DOI: | 10.3816/CCC.2008.n.032 |
| PUBMED: | 18650193 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 14" - "Export Date: 17 November 2011" - "CODEN: CCCLC" - "Source: Scopus" |
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