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Feasibility study of ambulatory continuous infusion of 5-fluorouracil followed by cisplatin through hepatic artery for metastatic colorectal cancer

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Abstract

Purpose: A great synergy has been reported in a number of preclinical studies when 5-fluorouracil (5-FU) precedes cisplatin (CDDP). The objective of this study was to determine the feasibility of ambulatory continuous infusion of 5-FU followed by CDDP through hepatic artery for metastatic colorectal cancer. Patients and methods: Seventeen patients with unresectable liver metastases, who underwent primary tumor resection, were treated with 5-FU (450 mg/m2/day) for seven consecutive days followed by CDDP (100 mg/body/week) for seven consecutive days, each administered continuously by using a balloon pump via Infuse-A-Port catheter inserted into common hepatic artery. The doses of drugs were reduced 20% in patients older than 70 years. The treatment was repeated every 4–6 weeks until disease progression. Results: Of 17 assessable patients, nine patients showed PR (53%; 95% CI, 29.3–76.7%) and eight patients had SD (47%; 95% CI, 23.3–70.7%), with disease control rate of 100%. The median overall survival was 26 months (95% CI: 17.5–41 months) and TTP 14 months (95% CI: 11–20.3 months). Two patients (11.8%), who showed progression due to collateral feeding arteries, responded to HAI again after occlusion. Grade 3 toxicity included leukopenia (12%) and anemia (24%). Grade 4 toxicity was absent. Four patients (23.5%) progressed at extrahepatic sites. Conclusions: This sequential combination of 5-FU followed by CDDP through hepatic artery is active and safe in an outpatient setting, and warrants further multi-institutional study, although prevention of micrometastasis would be mandatory to further prolong overall survival.

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Authors and Affiliations

  1. First Department of Internal Medicine and Department of Biosystemic Science of Medicine, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Baoli Qin, Ken Kato, Kenji Mitsugi, Minoru Nakamura, Risa Tanaka, Eishi Baba, Hiroshi Ariyama, Mine Harada & Shuji Nakano

  2. Department of Radiology, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Toshiro Kuroiwa

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  1. Baoli Qin
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  2. Ken Kato
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Correspondence to Shuji Nakano.

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Qin, B., Kato, K., Mitsugi, K. et al. Feasibility study of ambulatory continuous infusion of 5-fluorouracil followed by cisplatin through hepatic artery for metastatic colorectal cancer. Cancer Chemother Pharmacol 57, 114–119 (2006). https://doi.org/10.1007/s00280-005-0021-8

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  • DOI: https://doi.org/10.1007/s00280-005-0021-8

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