Hepatic arterial infusion for hepatic metastases from Colon Cancer

Background: Sixty percent of colon cancer patients develop liver metastasis. Only 25% of those have potentially resectable hepatic metastases. Hepatic metastases drive most of their blood supply from the hepatic artery; therefore hepatic arterial infusion (HAI) of chemotherapy may improve outcome. Methods: In a phase II clinical trial, 10 patients received HAI of 5-FU, Leucovorin and dexametasone in addition to intravenous irinotecin . End points of the study were response rate, overall and disease free survival. Results: Four patients showed partial response (40%), four had stable disease (40%) and disease progressed in two patients (20%). Median disease free survival was 8 months and median overall survival was 18 months. Five patients are alive. Complication included one catheter displacement and one obstruction of the port lead to treatment cessation. There were not any chemical hepatitis or biliary sclerosis. Conclusion: Hepatic arterial infusion of 5-FU in combination with systemic irinotecan is effective, feasible and safe in the treatment of hepatic metastases from colorectal cancer.