Regional and systemic chemotherapy for primary hepatobiliary cancers and for colorectal cancer metastatic to the liver Journal Article
| Authors: | Chung, K. Y.; Kemeny, N. |
| Article Title: | Regional and systemic chemotherapy for primary hepatobiliary cancers and for colorectal cancer metastatic to the liver |
| Abstract: | Hepatic arterial infusional (HAI) chemotherapy is based on the premise that primary and metastatic tumors derive their blood supply from the hepatic artery, whereas normal liver derives its blood supply from the portal vein. This approach has been extensively studied in liver-only colorectal metastasis patients, with 10 published prospective randomized clinical trials comparing fluoropyrimidine-based HAI therapy with systemic chemotherapy. Most of these studies showed a statistically significant superior response rate and improved disease-free survival with HAI chemotherapy compared with systemic fluoropyrimidine-based chemotherapy alone. More advanced chemotherapeutic regimens including biologically targeted agents have clearly impacted survival in metastatic colorectal cancer patients and are currently under investigation with HAI-based trials. In contrast, hepatobiliary tumors remain difficult to treat with overall poor response and survival with systemic chemotherapy. Few clinical trials have attempted to address the role of HAI-based therapy for these regional tumors, although encouraging response rates up to 60% have been reported. Therefore, the regional approach for hepatobiliary tumors deserves further investigation as well as randomized trials for adequate comparison to new systemic chemotherapies. © 2005 Elsevier Inc. All rights reserved. |
| Keywords: | cancer chemotherapy; cancer survival; cancer surgery; clinical trial; mortality; neutropenia; review; bevacizumab; cisplatin; doxorubicin; erlotinib; fluorouracil; iodinated poppyseed oil; chemoembolization; diarrhea; liver cell carcinoma; systemic therapy; carcinoma, hepatocellular; liver neoplasms; capecitabine; gemcitabine; paclitaxel; adjuvant therapy; chemotherapy; colorectal cancer; alpha2b interferon; carboplatin; unindexed drug; etoposide; mucosa inflammation; antineoplastic combined chemotherapy protocols; dexamethasone; vascularization; cetuximab; docetaxel; irinotecan; postoperative complication; colorectal neoplasms; liver metastasis; liver; statistical significance; randomized controlled trials; folinic acid; stomach ulcer; mitoxantrone; infusions, intra-arterial; liver resection; epirubicin; mitomycin c; bile duct carcinoma; taxane derivative; gallbladder carcinoma; anthracycline; oxaliplatin; risk reduction; floxuridine; fluoropyrimidine; exatecan; portal vein; artery thrombosis; biliary tract neoplasms; hepatic artery; small intestine obstruction; digestive system surgical procedures; biliary tract tumor; artery injury; infusion pump; liver perfusion; folfiri; folfox; liver arteriography; gastritis; microsphere; yttrium 90; hepatobiliary; hepatobiliary system cancer; hepatobiliary system tumor; hepatic arterial infusional; folic acid derivative |
| Journal Title: | Seminars in Radiation Oncology |
| Volume: | 15 |
| Issue: | 4 |
| ISSN: | 1053-4296 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2005-10-01 |
| Start Page: | 284 |
| End Page: | 298 |
| Language: | English |
| DOI: | 10.1016/j.semradonc.2005.04.007 |
| PUBMED: | 16183483 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 4" - "Export Date: 24 October 2012" - "CODEN: SRONE" - "Source: Scopus" |
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