Randomized study of intrahepatic (H) versus systemic (S) infusion of fluorodeoxyuridine (FUDR) in patients with liver metastases from colorectal carcinoma (CRC) Meeting Abstract
| Authors: | Kemeny, N.; Daly, J. |
| Abstract Title: | Randomized study of intrahepatic (H) versus systemic (S) infusion of fluorodeoxyuridine (FUDR) in patients with liver metastases from colorectal carcinoma (CRC) |
| Meeting Title: | Anticancer Drugs: Therapeutic Index Improvement by Toxicity Reduction |
| Series Title: | Cancer Treatment Reviews |
| Abstract: | Previously untreated patients with only liver metastases from CRC were randomized to either intrahepatic (H) or systemic (S) infusion of fluorodeoxyuridine (FUDR). The dose was 0.3 and 0.125 mg/kg/day for 14 days per month in the H and S groups, respectively. All patients underwent exploratory laparotomy to evaluate the extent of liver involvement and to assure the absence of extrahepatic disease. In the H group, the Infusaid pump was connected to hepatic artery; in the S group, the pump was connected to a venous catheter, while the hepatic artery catheter was connected to an infus-a-port, thereby allowing crossover to H therapy if disease progressed on S therapy. Of 178 patients referred to entry into the study, 63 did not have pumps placed because of extrahepatic disease (n = 33), resectable disease (n = 25), no tumor (n = 4), and infection (n = 1). Of the remaining 99 patients, 48 were randomized to H, and 51 to S. The two groups were well-matched for all variables including PS, percentage of liver involvement, and baseline LDH. Partial remissions (>50% reduction in measurable disease) were seen in 24/45 (50%) evaluable patients on H therapy, vs 10/48 (20%) on S. Extrahepatic progression occurred in 27/48 of H and 18/51 of S patients. Toxicity included ulcer disease or gastritis in 25%, bilirubin > 3 mg/dl in 19%, and biliary sclerosis in 8% of patients in the H group. The dose limiting toxicity for the S group was diarrhea (70%). More than half of the S group underwent a crossover to H, and 58% of crossovers had a response or stabilization of disease on H after tumor progression on S. Median survivals are presently 17 and 12 months in H and S groups, respectively. If the systemic group is divided into those who crossed over to H and versus those who did not have a crossover (usually for mechanical reasons), the median survivals are presently 18 and 8 months, respectively. This study suggests that intrahepatic therapy increases response rate and appears to be a more effective way of treating hepatic metastases from colorectal carcinoma. © 1987. |
| Keywords: | controlled study; major clinical study; clinical trial; randomized controlled trial; colorectal carcinoma; liver metastasis; floxuridine; intravenous drug administration; abstract report; human |
| Journal Title: | Cancer Treatment Reviews |
| Volume: | 14 |
| Issue: | 3-4 |
| Meeting Dates: | 1987 Apr 6-7 |
| Meeting Location: | London, UK |
| ISSN: | 0305-7372 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1987-12-01 |
| Start Page: | 245 |
| Language: | English |
| DOI: | 10.1016/0305-7372(87)90013-2 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 5 February 2021 -- Source: Scopus |
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