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Regional and systemic chemotherapy for advanced colorectal cancer

A review

  • Published:
Diseases of the Colon & Rectum

Abstract

Progress in regional arterial infusion therapy for metastatic cancer confined to the liver from colorectal primary and in systemic chemotherapy for widespread disease has been limited. Despite considerable search for effective antitumor agents, only few drugs have been shown to have efficacy to warrant additional evaluation alone or in multidrug regimens. Despite high response rates reported with regional therapy and some of the systemic chemotherapy regimens, significant prolongation of the overall survival on these treatment programs remains to be documented. Although chemotherapy for advanced large bowel cancer is only moderately effective at present, patients do obtain substantial benefit occasionally. Thus, chemotherapy should be attempted and there should be trials of new treatment regimens to find effective treatments for these patients.

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References

  1. Bedikian AY, Bodey GP, Valdivieso M, et al. In: Stroehlein JR, Romsdahl MM, eds: Chemotherapeutic management of colorectal cancer and prospects for new agents. In gastrointestinal cancer. New York: Raven Press. 1981:356–80.

    Google Scholar 

  2. Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver. Cancer 1969;23: 198–202.

    Article  PubMed  CAS  Google Scholar 

  3. MacDonald JS, Kisner DF, Smythe T, Wooley PV, Smith L. Jr., Schein PS. 5-Eluorouracil (5-Fu), methyl CCNU, and vincristine in the treatment of advanced colorectal cancer: phase II study utilizing weekly 5-FU. Cancer Treat Rep 1976;60: 1597–600.

    PubMed  CAS  Google Scholar 

  4. Wood CB, Gillis CR, Blumgart LH. A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol 1976;2:285–93.

    PubMed  CAS  Google Scholar 

  5. Foster JH. Survival after liver resection for secondary tumors. Am J Surg 1978;135:389–94.

    Article  PubMed  CAS  Google Scholar 

  6. Attiyeh FF, Wanebo HJ, Stearns MW Jr. Hepatic resection for metastasis from colorectal cancer. Dis Colon Rectum 1978;21: 160–2.

    PubMed  CAS  Google Scholar 

  7. Ensminger WD, Rosowsky A, Raso V, et al: A clinical-pharmacological evaluation of hepatic arterial infusions of 5-fluoro-2-deoxyuridine and 5-fluorouracil. Cancer Res 1978;38:3784–92.

    PubMed  CAS  Google Scholar 

  8. Ansfield FJ, Ramirez G, Davis HL, et al. Further clinical studies with intrahepatic arterial infusion with 5-fluorouracil. Cancer 1975;36:2413–7.

    Article  PubMed  CAS  Google Scholar 

  9. Watkins E, Khazei AM, Nahra KS. Surgical basis for arterial infusion chemotherapy of disseminated carcinoma of the liver. Surg Gynecol Obstet 1970;130:580–605.

    Google Scholar 

  10. Cady B, Oberfield RA. Regional infusion chemotherapy of hepatic metastases of carcinoma of the colon. Am J Surg 1974;127:220–7.

    Article  PubMed  CAS  Google Scholar 

  11. Buroker T, Samson M, Correa J, Fraile R, Vaitkevicius VK. Hepatic artery infusion of 5-FUDR after prior systemic 5-fluouracil. Cancer Treat Rep 1976;60:1277–9.

    PubMed  CAS  Google Scholar 

  12. Oberfield RA, McCaffrey JA, Polio J, Clouse ME, and Hamilton T. Prolonged and continuous percutaneous intra-arterial hepatic infusion chemotherapy in advanced adenocarcinoma from colorectal primary. Cancer 1979;44:414–23.

    Article  PubMed  CAS  Google Scholar 

  13. Smiley S, Schouten J, Chang A, Ramrrez G. Intrahepatic arterial infusion with 5-Fu for liver metastases of colorectal carcinoma. Proc AACR and ASCO 1981;22:391.

    Google Scholar 

  14. Berger M. Hepatic infusions for metastatic colorectal carcinoma in a community hospital setting. Proc AACR and ASCO 1981; 22:456.

    Google Scholar 

  15. Reed ML, Vaitkevicius VK, Al-Sarraf M et al. The practicality of chronic hepatic artery infusion therapy of primary and metastatic hepatic malignancies: ten-year results of 124 patients in a prosective protocol. Cancer 1981;17:402–9.

    Article  Google Scholar 

  16. Patt YZ, Bedikian AY, Chuang VP, Wallace S, Fuqua R, and Mavligit GM. New approaches to the treatment of Dukes' C colorectal carcinoma and metastatic colorectal carcinoma confined to the liver. In: Gastrointestinal Cancer. Stroehlein JR, and Romsdahl MM, eds. New York: Raven Press, 1981:391–403.

    Google Scholar 

  17. Theodors A, Bukowski RM, Hewlett JS, Weick F, Groppe C and Livingston RB. Phase II study of hepatic artery infusion (HAI) with 5-Fu and mitomycin C (MITO C) in metastatic colorectal carcinoma. Proc. AACR and ASCO 1981;22:162.

    Google Scholar 

  18. Grage TB, Vasilopoulos PP, Shingleton WW, et al. Results of a prospective randomized study of hepatic artery infusion with hepatic metastases from colorectal cancer: A Central Oncology Group Study. Surgery 1979;86:550–5.

    PubMed  CAS  Google Scholar 

  19. Strochlein JR, Bedikian AY, Karlin DA et al. A randomized study of oral ftorafur vs IV 5-fluorouracil in advanced colorectal cancer. Proc AACR and ASCO 1981;22:451.

    Google Scholar 

  20. Bedikian AY. Treatment of common malignant neoplasms of digestive system: An overview. In Proceedings of 26th Annual Clinical Conference on Cancer, 1981, Cancer 2001: An International Colloquium (In press)

  21. Moertel CG, Schutt AJ, Hahn RG, Reitemeier RJ. Therapy of advanced gastrointestinal cancer with a combination of 5-Fu, methyl CCNU, and vincristine. J Natl Cancer Inst 1975;54: 69–71.

    PubMed  CAS  Google Scholar 

  22. Falkson G, and Falkson HC. Fluorouracil methyl CCNU and vincristine in cancer of the colon. Cancer 1976;38:1468–70.

    Article  PubMed  CAS  Google Scholar 

  23. Moertel CG, O'Connell MJ, Ritts RE, et al. A controlled evaluation of combined immunotherapy (MER-BCG) and chemotherapy for advanced colorectal cancer. In: Immunotherapy of Cancer: Present status of trials in man, Terry WD, Windhorst T, Windhorst D, eds. New York: Raven Press, 1978;573–86.

    Google Scholar 

  24. Kemeny N, Yagoda A, Braun D, Jr., and Goldbey R. A randomized study of two different schedules of methyl CCNU (me CCNU), 5-fluorouracil (5-Fu) and Vincristine (VCR) for metastatic colorectal carcinoma. Cancer 1979;43:78–82.

    Article  PubMed  CAS  Google Scholar 

  25. Joss RA, Goldberg RS, and Yates JW. Combination chemotherapy of colorectal cancer with 5-fluorouracil, methyl 1,3-cis (2-chlorethyl)-1-nitrosourea and vincristine. Med Pediatric Oncol 1979;7:251–5.

    CAS  Google Scholar 

  26. Engstrom P, MacIntyre J, Douglas H Jr., and Carbone P for Eastern Cooperation Oncology Group. Combination chemotherapy of advanced bowel cancer. Proc AACR and ASCO 1980;21:384.

    Google Scholar 

  27. Kemeny N, Yagoda A, GoldbeyRA. Prospective randomized study of methyl CCNU, 5-fluorouracil and vincristine (MOF) plus streptozotocin (MOF-strep) in patients with metastatic colorectal cancer. Proc AACR and ASCO 1980;21:417.

    Google Scholar 

  28. Naglas M, Kmetec A. Randomized prospective trial comparing two treatment schedules of 5-fluorouracil, methyl CCNU and vincristine in advanced colorectal cancer. Radiol Iugosl 1980;14:549–52.

    Google Scholar 

  29. Winn R, Kampel L, Berger R, Schreiebman S, Mackey R, Yagoda A. A randomized trial of semustine (M), vincristine (0), 5-fluorouracil (F) (MOF-S) in advanced colorectal carcinoma. Proc AACR and ASCO 1981;22:459.

    Google Scholar 

  30. Stone L, Hoeltgen TM, Perlia CP, Wolter J. Combination chemotherapy of disseminated GI adenocarcinoma with vincristine (VCR), methyl (CCNU and 5-fluorouracil) (5-Fu). Proc AACR and ASCO 1977;18:326.

    Google Scholar 

  31. Ravry MJ. Three different schedules of methyl CCNU (MMU) plus 5-fluorouracil (5-Fu). Proc AACR and ASCO 1977;18:298.

    Google Scholar 

  32. Pratt CB, Terrell W, Shouks E. Carcinoma of the colon in adolescents: Treatment with Vincristine, methyl CCNU and 5-fluorouracil. Proc AACR and ASCO 1976;17:25.

    Google Scholar 

  33. Buroker T, Kim PN, Groppe C, et al. 5-Fu infusion with mitomycin C vs 5-Fu infusion with methyl CCNU in the treatment of advanced colon cancer. Cancer 1978;42:1228–33.

    Article  PubMed  CAS  Google Scholar 

  34. Weltz M, Perry D, Blom J et al. Methyl CCNU (MeCCNU) Vincristine (VCR), 5-fluorouracil (5-Fu) and Streptozotocin (MOFS) in metastatic colorectal carcinoma. Proc AACR and ASCO 1981;22:454.

    Google Scholar 

  35. Kufe D. Metabolic enhancement of 5-fluorouracil (5-Fu) incorporation into human cell RNA. Proc AACR and ASCO 1980; 21:265.

    Google Scholar 

  36. Ardalan B, Glazer R, Kensler T, et al. Biochemical mechanisms for the synergism of 5-fluorouracil (5-Fu) and phosphonacetyl-L-aspartate (PALA) in mammary carcinoma cells. Proc AACR and ASCO 1980;21:8.

    Google Scholar 

  37. Bertino JR, Sawicki WL, Lindquist CA, et al. Schedule dependent antitumor effects of methotrexate and 5-fluorouracil. Cancer Res 1977;27:327–8.

    Google Scholar 

  38. Woodcock TM, Martin DS, Damin LM, Kemeny NE, Young CW. Combination clinical trials with thymidine and fluorouracil: a phase I and clinical pharmacological evaluation. Cancer 1980;45:1135–43.

    Article  PubMed  CAS  Google Scholar 

  39. Bedikian AY, Stroehlein JR, Karlin DA, et al. Chemotherapy for colorectal cancer with a combination of PALA and 5-Fu. Cancer Treat Rep 1981;65:747–53.

    PubMed  CAS  Google Scholar 

  40. Camacho FJ, Muggia FM, Kaplan BH. A trial of N-(phosphonacetyl)-L-Asparatate (PALA) and 5-fluorouracil (FU) in patients with metastatic colorectal cancer. Proc AACR and ASCO 1981;22:457.

    Google Scholar 

  41. Tisman G, Wu SJ. Effectiveness of intermediate-dose methotrexate and high-dose 5-fluorouracil as sequential combination chemotherapy in refractory Breast cancer and as a primary therapy in metastatic adenocarcinoma of the colon. Cancer Treat Rep 1980;64:829–35.

    PubMed  CAS  Google Scholar 

  42. Drapkin R, Griffiths E, MacAloon E, Paladine W, Sokol G, Lyman G. Sequential methotrexate (MTX) and 5-fluorouracil (5-Fu) in adenocarcinoma of the colon and rectum. Proc AACR and ASCO 1981;22:453.

    Google Scholar 

  43. Weinerman B, Schipper H, Bowman D, Levitt M 5-Fluorouracil (F), Methotrexate (M) and Leukovorin Rescue (LR) in the treatment of metastatic colorectal cancer (CRC). Proc AACR and ASCO 1981;22:450.

    Google Scholar 

  44. Burnet R, Smith FP, Hoerni B, Lagarde C, Schein P. Sequential methotrexate-5-fluorouracil in advance measurable colorectal cancer; Lack of appreciable therapeutic synergism. Proc AACR and ASCO 1981;22:370.

    Google Scholar 

  45. Hermann R, Managolo O, Rittinghausen R, Fritze D, Schettler G. Sequential methotrexate (MTX) and 5-fluorouracil (FU) in colorectal adenocarcinoma. Results of a pilot study. Proc AACR and ASCO 1981;22:457.

    Google Scholar 

  46. Solan A, Vogl SE, Kaplan BH, Lanhorn R, Bulkin W, Berenzweig M. 5-Fluorouracil (FU) and methotrexate (MTX) in combination for colorectal cancer: Unacceptable toxicity when intermediate dose MTX precedes FU by 4 hours. Proc AACR and ASCO 1980;21:335.

    Google Scholar 

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Bedikian, A.Y. Regional and systemic chemotherapy for advanced colorectal cancer. Dis Colon Rectum 26, 327–332 (1983). https://doi.org/10.1007/BF02561709

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  • DOI: https://doi.org/10.1007/BF02561709

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