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Intermittent hepatic arterial infusion of high-dose fluorouracil on a weekly schedule as adjuvant chemotherapy following curative resection of colorectal liver metastases: a randomized study



Intermittent hepatic arterial infusion of high-dose fluorouracil on a weekly schedule as adjuvant chemotherapy following curative resection of colorectal liver metastases: a randomized study



Journal of Clinical Oncology 23(16_Suppl): 3727-3727



NlmCategory="UNASSIGNED">3727 Background: More than half of patients received curative resection of liver metastases from colorectal carcinoma develops recurrent disease in the residual liver. The authors have reported the efficacy of short-term hepatic arterial infusion (HAI) of 5-fluorouracil (5-FU) in preventing the hepatic recurrence (Cancer 88: 1549, 2000). In this paper the usefulness of intermittent HAI chemotherapy of high dose 5-FU on a weekly schedule was investigated. Thirty-eight patients were randomly assigned into 2 groups. Nineteen patients received 1500 mg of 5-FU intra-arterially for 5 h once a week for 8 weeks (WH-HAI group). AS a control, the remaining 19 cases received continuous infusion of 5-FU (500 mg/d) for 4 days (96h) per week in 6 weeks (C-HAI group). The latter regimen had been established in our previous study. In both protocols, the total dosage of 5-FU was 12g, and the treatment was performed using disposable infusion pumps. In terms of the patient characteristics including age, sex, Dukes' stage, tumor size, chronology, number of tumor, location of tumor and type of hepatectomy, there was no statistically significant difference between the two groups. The median follow-up period was 47.4 months. The recurrence was confirmed in 12 cases of each group, and, of those, 4 patients of each group had recurrent disease in the residual liver. The 1-, 2-, 3-year hepatic disease free survival were 80, 74 and 74% in WH-HAI group, respectively, and 83, 78 and 78%, in C-HAI group, respectively (p=0.7989). No patients of either group suffered any adverse effect of Grade 3 or more. Five cases of WH-HAI group and 6 from C-HAI group were dead of disease. The 1-, 3- and 5-year cumulative survival of WH-HAI group were 90, 78 and 78%, respectively, whereas those of C-HAI group were 100, 68 and 68%, respectively (p=0.9237). As an adjuvant chemotherapy following curative resection of colorectal liver metastases, a new weekly administration of high-dose 5-FU regimen, which seems more simple and convenient, showed a similar effect to continuous HAI protocol in preventing the hepatic recurrence without any serious complication. No significant financial relationships to disclose.

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Accession: 058139754

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PMID: 27945565


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