Annals of Surgical Oncology

, Volume 15, Issue 1, pp 219–226 | Cite as

Hepatic Arterial Infusion of Oxaliplatin and Intravenous LV5FU2 in Unresectable Liver Metastases from Colorectal Cancer after Systemic Chemotherapy Failure

  • Valérie Boige
  • David Malka
  • Dominique Elias
  • Marine Castaing
  • Thierry De Baere
  • Diane Goere
  • Clarisse Dromain
  • Marc Pocard
  • Michel Ducreux
Gastrointestinal Oncology Original Papers



We have previously shown promising activity of hepatic arterial infusion (HAI) oxaliplatin combined with intravenous (IV) 5-fluorouracil (5-FU) and leucovorin (LV) as first-line chemotherapy in patients with colorectal liver metastases (CRLM) (intent-to-treat [ITT] objective response rate [ORR], 64%; secondary resection rate, 18%; overall survival [OS], 27 months). Whether this regimen could be beneficial after systemic chemotherapy failure is unknown.


Patients with unresectable CRLM and history of systemic chemotherapy failure were treated bimonthly with HAI oxaliplatin (100 mg/m2 2 hours) combined with IV LV and IV bolus and infusional 5FU (modified LV5FU2 regimen).


Forty-four consecutive patients (median age 56 years; median number of prior systemic chemotherapy regimens, 2 range 1–5) were included, of whom 43 (98%) had previously received oxaliplatin (n = 34), irinotecan (n = 37), or both (n = 28). Patients received a median of nine cycles of HAI oxaliplatin and IV modified LV5FU2 (range 0–25). Toxicity included grade 3–4 neutropenia (43%), grade 2–3 neuropathy (43%), and grade 3–4 abdominal pain (14%). We observed 24 partial ORs (62%) among the 39 assessable patients (ITT ORR, 55%; 95% CI, 40–69%), including 17, 12, and 12 patients who had failed to respond to prior systemic chemotherapy with FOLFIRI, FOLFOX, or both, respectively. Tumor response allowed further R0 surgical resection (n = 7) or radiofrequency ablation (n = 1) of initially unresectable CRLM in eight patients (18%). Median progression-free survival and OS were 7 and 16 months, respectively.


HAI oxaliplatin and IV LV5FU2 is feasible, safe, and shows promising activity after systemic chemotherapy failure, allowing surgical resection of initially unresectable CRLM in 18% of patients.


Colorectal cancer Liver metastases 5-fluorouracil Oxaliplatin Regional chemotherapy 


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Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Valérie Boige
    • 1
  • David Malka
    • 1
  • Dominique Elias
    • 2
  • Marine Castaing
    • 3
  • Thierry De Baere
    • 4
  • Diane Goere
    • 2
  • Clarisse Dromain
    • 4
  • Marc Pocard
    • 2
  • Michel Ducreux
    • 1
  1. 1.Department of MedicineInstitut Gustave RoussyVillejuifFrance
  2. 2.Department of SurgeryInstitut Gustave RoussyVillejuifFrance
  3. 3.Department of BiostatisticsInstitut Gustave RoussyVillejuifFrance
  4. 4.Department of RadiologyInstitut Gustave RoussyVillejuifFrance

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