Document Detail


Regional chemotherapy for hepatic metastases of colorectal carcinoma (continuous intraarterial versus continuous intraarterial/intravenous therapy). Results of a controlled clinical trial.
MedLine Citation:
PMID:  2525415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sixty-four patients with a biopsy diagnosis of colorectal cancer with liver metastases were treated with 5-fluorodeoxyuridine (FUDR) infusions. In a pilot study, the first 20 patients were given hepatic artery infusions of FUDR by implanted pumps. The remaining 44 patients were then randomized prospectively to compare the effectiveness of continuous hepatic artery and intravenous infusion of FUDR (IA/IV group; 21 patients) with hepatic artery infusion alone (IA group; 23 patients). A continuous 14-day infusion regimen of FUDR was applied each month. The dosage was 0.2 mg/kg/d of FUDR for the IA group and 0.3 mg/kg/d for the IA/IV group. The complete and partial response rates were each 50% in the pilot study and 52% and 48% in the IA and IA/IV randomized groups, respectively. Drug toxicities in the 64 patients included gastroenteritis (21%), chemical hepatitis (57%), and biliary sclerosis (25%). There was no difference in the toxicity of FUDR in the two randomized groups (P greater than 0.1). Extrahepatic spread of cancer during therapy was found in 61% (n = 14) of the IA group and 33% (n = 7) of the IA/IV group. There was no difference in survival between the randomized groups. The 64 patients were categorized into the following two groups according to their response to therapy: (1) responders (patients with complete or partial remission [n = 32]) or nonresponders (patients with stable disease or progression of metastases [n = 32]). The median survival time was 31 months for responders and 16 months for nonresponders (P less than 0.0001). Intraarterial FUDR infusion provided control of liver metastases. The combination of intraarterial and intravenous therapy seemed to prevent extrahepatic spread during therapy in most of the patients. Survival appeared to be significantly prolonged in patients with a regression of metastases.
Authors:
F Safi; R Bittner; R Roscher; K Schuhmacher; W Gaus; G H Beger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cancer     Volume:  64     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-07-28     Completed Date:  1989-07-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  379-87     Citation Subset:  AIM; IM    
Affiliation:
Department of General Surgery, University of Ulm, West Germany.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / drug therapy*,  mortality
Carcinoembryonic Antigen / analysis
Clinical Trials as Topic
Colorectal Neoplasms / drug therapy*,  mortality
Female
Floxuridine / administration & dosage*,  adverse effects
Humans
Infusion Pumps
Infusions, Intra-Arterial
Infusions, Intravenous
Liver Neoplasms / drug therapy,  mortality,  secondary*
Male
Middle Aged
Postoperative Complications
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Carcinoembryonic Antigen; 50-91-9/Floxuridine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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