Science Links Japan | Basic Research Supported Developments of Chemotherapy in Nonresectable Isolated Colorectal Liver Metastases to a Protocol of Hepatic Artery Infusion Using Mitoxantrone, 5-FU+Folinic Acid and Mitomycin C.

Basic Research Supported Developments of Chemotherapy in Nonresectable Isolated Colorectal Liver Metastases to a Protocol of Hepatic Artery Infusion Using Mitoxantrone, 5-FU+Folinic Acid and Mitomycin C.

Accession number;99A0286461

Title;Basic Research Supported Developments of Chemotherapy in Nonresectable Isolated Colorectal Liver Metastases to a Protocol of Hepatic Artery Infusion Using Mitoxantrone, 5-FU+Folinic Acid and Mitomycin C.

Author; LINK K-H (Univ. Ulm, Ulm, Deu) KORNMANN M (Univ. Ulm, Ulm, Deu) LEDER G (Univ. Ulm, Ulm, Deu) PILLASCH A F J (Univ. Ulm, Ulm, Deu) SUNELAITIS E (Univ. Ulm, Ulm, Deu) SCHATZ M (Univ. Ulm, Ulm, Deu) PRESSMAR J (Univ. Ulm, Ulm, Deu) BEGER H G (Univ. Ulm, Ulm, Deu)

Journal Title;Japanese Journal of Cancer and Chemotherapy

Journal Code:Z0938A

ISSN:0385-0684

VOL.26;NO.3;PAGE.269-281(1999)

Figure&Table&Reference;TBL.3, REF.37

Pub. Country;Japan

Language;English

Abstract;Objective: Since the developments in systemic chemotherapy of metastasized colorectal cancer have not resulted in substantial gains in survival times, we wished to improve the course of isolated nonresectable colorectal liver metastases(CPLM) by hepatic arterial infusion treatment. Background: Patients(pts) with CRLM have a worse fate than those pts whose liver metastases could be resected. Systemic(i.v.) chemotherapy for CRLM/colorectal metastases does not improve survival to a relevant level(median survival time(med. surv.) after 5-Fluorouracil+Folinic Acid(5-FU+FA) i.v.: 6.4-14.3 months(m)). Hepatic artery infusion(HAI) with 5-Fluorode-oxyuridine(5-FUDR) has been demonstrated in a metaanalysis of randomized trials to be superior to i.v. treatment/palliative care(med. surv.: 15 vs. 10m). The benefit of HAI with 5-FUDR, although recommended as treatment for CRLM, is severely compromised by the 5-FUDR induced hepatotoxicity, leading eventually to sclerosing cholangitis(SC)/liver scirrhosis. We have stepwise developed a protocol for HAI of CRLM, which is superior to HAI with 5-FUDR, and, most evidently, to systemic chemotherapy. Patients/Methods: Between 1982-1997, 222 CR(L) M patients were treated within subsequent protocols(Table). In protocol A, 68 CRLM pts received HAI with 5-FUDR(A1: nonrandomized pts; A2: randomized pts). In protocol B(randomized pts.), 46 pts received 5-FUDR i.a.(via HAI)+i.v.. In protocol C, systemic chemotherapy with 5-FU+FA was conducted in 34 pts with metastasized colorectal cancers, including CRLM. In protocol D 5-FU+FA was delivered via HAI in 25 pts with CRLM. In protocol E, based on in vitro phase II studies and the results of protocol D, Mitoxantrone and Mitomycin C were added to 5-FU+FA(MFFM). Fifty(50) CRLM pts received HAI with MFFM.... (author abst.)

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