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5-FU or mitomycin C hepatic arterial infusion after failure of arterial oxaliplatin in patients with colorectal cancer unresectable liver metastases
- Source :
- Clinics and Research in Hepatology and Gastroenterology. 42:255-260
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Summary Introduction Hepatic arterial infusion (HAI) chemotherapy with oxaliplatin is an accepted option in the management of colorectal cancer (CRC) with dominant liver metastases (LM). However, despite prolonged control, some patients experience disease progression. On the other hand, oxaliplatin leads to dose-limiting toxicity. In these cases, the use of a second-line HAI with an alternative drug has never been reported to date. We evaluated treatment outcomes in patients receiving second-line HAI with 5-FU or mitomycin C, after first-line HAI of oxaliplatin in heavily pretreated patients. Material and methods Between March 2010 and June 2016, this observational study included 24 patients with unresectable CRC LM and treated with HAI of 5-FU (17 patients) or mitomycin C (7 patients), after HAI of oxaliplatin. Results Mean age was 61.7 years. Forty-two percent of patients (10/24) had extra-hepatic metastases and 75% (18/24) at least 8 liver metastases. Including HAI of oxaliplatin, all patients had previously received at least 2 lines of chemotherapy ± targeted agents (100%) and 96% (23/24) received concomitant systemic therapies together with HAI of 5-FU or mitomycin C. The overall objective response rate and disease control rate were, respectively, 42% (10/24) and 71% (17/24). Median progression-free survival and overall survival (OS) were, respectively, 5.6 and 25.8 months; hepatic progression-free survival was 8.5 months. Thirteen percent (3/24) of the patients received further curative intent treatment after HAI 5-FU and mitomycin C. No toxic death occurred and the toxicity profile was acceptable. Conclusions HAI of 5-FU or mitomycin C is an alternative option in patients with predominant CRC LM, when they experience disease progression or do not tolerate HAI of oxaliplatin.
- Subjects :
- Adult
Male
medicine.medical_specialty
animal structures
Colorectal cancer
Mitomycin
medicine.medical_treatment
Antineoplastic Agents
Gastroenterology
030218 nuclear medicine & medical imaging
03 medical and health sciences
Hepatic Artery
0302 clinical medicine
Hepatic arterial infusion
Internal medicine
medicine
Humans
Infusions, Intra-Arterial
In patient
Treatment Failure
Aged
Retrospective Studies
Aged, 80 and over
Chemotherapy
Hepatology
business.industry
Liver Neoplasms
Mitomycin C
virus diseases
Middle Aged
medicine.disease
Oxaliplatin
030220 oncology & carcinogenesis
Concomitant
Toxicity
Female
Fluorouracil
Colorectal Neoplasms
business
medicine.drug
Subjects
Details
- ISSN :
- 22107401
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Clinics and Research in Hepatology and Gastroenterology
- Accession number :
- edsair.doi.dedup.....3f19f534f49a529c83f17881c89d0c1c