Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma: A randomized trial Journal Article
| Authors: | Kemeny, N.; Daly, J.; Reichman, B.; Geller, N.; Botet, J.; Oderman, P. |
| Article Title: | Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma: A randomized trial |
| Abstract: | Objective: To compare the efficacy of direct hepatic arterial chemotherapy with systemic chemotherapy in patients with liver metastases from colorectal carcinoma. Design: Randomized trial with crossover allowed from systemic to intrahepatic therapy if tumor progression occurred on systemic therapy. Setting: Academic medical center, referral-based clinic. Patients: One hundred sixty-two patients with hepatic metastases from colorectal carcinoma agreed to be randomly assigned to treatment groups. At laparotomy, 63 were excluded from the study: 25 had hepatic resection; 33, extrahepatic disease; 1, infection; and 4, no tumor. Intervention: Fourteen-day continuous infusion of fluorodeoxyuridine each month using an Infusaid pump (0.3 and 0.15 mg/kg body weight·d in the intrahepatic and systemic arms, respectively). Main Results: Intrahepatic therapy produced a significantly higher complete and partial response rate, 50%, compared with 20% for systemic therapy (p = 0.001). After tumor progression, 60% of the systemic patients crossed over to intrahepatic therapy; 25% then had a partial response, and 33% a minor response or stabilization of disease on intrahepatic therapy. Toxicity included ulcer disease (17%) and biliary sclerosis (8%) in patients receiving intrahepatic therapy and diarrhea (70%) in patients receiving systemic therapy. Extrahepatic disease occurred in 56% and 37% of the patients in the intrahepatic and systemic groups, respectively (p = 0.092). The median survivals were 17 and 12 months, for the intrehepatic and systemic groups, respectively. Conclusion: When compared with systemic therapy, hepatic arterial chemotherapy significantly increases response rate for hepatic metastases from colorectal carcinoma and appears to be a more effective treatment. |
| Keywords: | cancer chemotherapy; major clinical study; colorectal carcinoma; liver metastasis; liver; floxuridine; therapy; large intestine; human |
| Journal Title: | Annals of Internal Medicine |
| Volume: | 107 |
| Issue: | 4 |
| ISSN: | 0003-4819 |
| Publisher: | American College of Physicians |
| Date Published: | 1987-10-01 |
| Start Page: | 459 |
| End Page: | 465 |
| Language: | English |
| DOI: | 10.7326/0003-4819-107-4-459 |
| PUBMED: | 2957943 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 5 February 2021 -- Source: Scopus |
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