Protracted hepatic arterial infusion with low-dose cisplatin plus 5-fluorouracil for unresectable liver metastases from colorectal cancer.

Abstract

Hepatic arterial infusion (HAI) chemotherapy is a treatment option for unresectable liver metastases from colorectal cancer, but it is not yet a standard treatment. The aims of this study were to demonstrate the efficacy of protracted HAI chemotherapy with low-dose cisplatin plus 5-fluorouracil for patients with unresectable liver metastases from colorectal cancer. Twenty-two patients with unresectable liver metastases from colorectal cancer were treated with continuous HAI of 300 mg/m2 5-fluorouracil for 5 days a week and 6 mg/m2 cisplatin for 2 hours on 5 consecutive days a week. The plasma concentrations of cisplatin and 5-fluorouracil during the treatment were measured for a pharmacokinetic study. Of the 22 patients, 2 had a complete response, 13 had a partial response, 6 had stable disease, and 1 had progressive disease, and the response rate was 68% (15/22). The median survival time was 17 months, and 1-, 2-, and 3-year survival rates were 59%, 26%, and 13%, respectively. Progressive disease was the reason for treatment discontinuation in 10 (45%) of the 22 patients, and 9 (41%) patients had to stop the treatment because of complications. Systemic toxicity was minimal. The pharmacokinetic study showed a high degree of hepatic extraction for both cisplatin and 5-fluorouracil during the treatment. The treatment regimen described herein thus appears to be efficacious regarding the tumor response and survival for patients with unresectable liver metastases from colorectal cancer.