Hepatic arterial chemotherapy with oxaliplatin, folinic acid and 5-fluorouracil in pre-treated patients with liver metastases from colorectal cancer.

BACKGROUND: Hepatic arterial chemotherapy (HAC) is an effective treatment of liver metastases from colorectal cancer (CRC). Phase I and II studies have already shown the feasibility and efficacy of intra-arterial oxaliplatin (OXA). PATIENTS AND METHODS: Twenty-one pre-treated patients with liver metastases who received HAC with OXA/folinic acid (FA)/5-fluorouracil (5-FU) at our Division between March 2000 and November 2003, were clinically examined. Most patients were heavily pre-treated with two or more systemic chemotherapeutic regimes. All patients received a percutaneously implanted catheter into the hepatic artery through femoral or transaxillary access. Treatment was administered every 14 days: OXA 100 mg/m2 as a 12-hour infusion on day 1; FA 100 mg/m2 as a 2-hour infusion on days 2 and 3; 5-FU 2600 mg/m2 as a continuous infusion on days 2 and 3. RESULTS: Grade 3-4 toxicities were: asthenia (2 out of 21), transaminase elevation (2 out of 21) and pain (2 out of 21), nausea and vomiting (1 out of 21), neutropenia (1 out of 21), thrombocytopenia (1 out of 21) and neurotoxicity (1 out of 21). Main dose limiting toxicity was right upper quadrant pain. Response rates were: 5% complete response, 19% partial response, 28% stable disease and 48% progressive disease. Two patients became operable and underwent complete resection of liver disease. The median overall survival was 36.1 months. Two-year and 3-year survival rates were 62% and 52%, respectively. CONCLUSION: This regimen is feasible with low toxicity and with an encouraging overall tumor growth control (52%) in a subset of heavily pre-treated patients. Intra-arterial OXA/FA/5-FU should be considered for the treatment of patients pre-treated with systemic chemotherapies with liver metastases from CRC.

Intra-arterial chemotherapy: a safe treatment for elderly patients with locally advanced breast cancer.

UNLABELLED: The feasibility, toxicity and local response rates of intra-arterial chemotherapy with 5-fluorouracil, epirubicin and mitomycin in patients over 75 years with locally advanced breast cancer was evaluated. PATIENTS AND METHODS: Ten patients were treated by the transfemoral Seldinger technique, with the catheter tip placed into the internal mammary artery. In order to evaluate the vessels perfusing the tumor, blue dye solution was infused before drug administration. The patients received 5-fluorouracil 750 mg/m2, epirubicin 30 mg/m2 and mitomycin 7 mg/m2 by bolus infusion. RESULTS: All patients were evaluated for toxicity and response. Twenty-two cycles were administered. The toxicity was mild and did not influence the patients' quality of life; the compliance was excellent. A response rate of 80% (8 out of 10) was obtained; the median overall survival was 33.5 months; no patient had local recurrence. CONCLUSION: Intra-arterial chemotherapy is an effective and safe treatment for locally advanced breast cancer in the elderly.