Hepatic arterial infusion chemotherapy for liver metastases from breast cancer

Abstract

Between 1985 and 1992, 56 patients with unresectable liver metastases from breast cancer were treated by repeated hepatic arterial infusion chemotherapy employing an implantable port system. 5-Fluorouracil (5-FU) at 330 mg/m2 per week. Adriamycin (ADR) at 20 mg/m2 every 4 weeks, and mitomycin C (MMC) at 2.7 mg/m2 every 2 weeks were given to 42 patients. The remaining 14 patients received 5-FU at 330 mg/m2 per week and epirubicin (EPIR) at 20 mg/m2 every 2 weeks. As a rule, the treatment was performed on an outpatient basis. The side effects and complications observed included myelosuppression (41%), hepatic arterial occlusion (23%), and gastric mucositis (20%), but no major toxicity was encountered. The response rate (CR+PR) of the evaluated patients as determined from CT scans was 81%. The overall median survival period was 12.5 months. Only 14% of the patients died due to regrowth of liver metastases, and in 70% of the total cases, death due to liver metastases was avoided by this treatment. Thus, repeated hepatic arterial infusion chemotherapy for liver metastases from breast cancer might be capable of prolonging the survival of patients via avoidance of death due to the liver metastases.

Making the Case: Intra-arterial Therapy for Less Common Metastases

“…Toxicities were grade 3/4 elevations in transaminases in four patients, one pump malfunction, and one hepatic arterial dissection complicated by occlusion of the common hepatic artery and pancreatitis. The overall response rate was 78%, similar to the 81% measured by Arai et al 15 The median time to progression of liver disease was 6 months. The median overall survival (OS) was 17 months.…”

Clinical efficacy and value of redistributed subclavian arterial infusion chemotherapy for locally advanced breast cancer

“…17,18 Effi cacy and safety of RESAIC Local response was evaluated by the change in the largest diameter of the lesion on a cross-sectional image [computed tomography (CT) in 21 cases and magnetic resonance imaging (MRI) in one case] using the Response Evaluation Criteria in Solid Tumors (RECIST) manual. 19 The scans were examined before and after (1, 3, and 5 months) the treatment started.…”

Palliative hepatic intraarterial chemotherapy (HIC) using a novel combination of gemcitabine and mitomycin C: results in hepatic metastases

“…Five PR, two SD and one PD were achieved, resulting in an OR of 63%. Median survival was 25.3 months and thus remarkably longer than in any other study on HIC in breast cancer with larger numbers of patients, in which median survival around 12 months is seen [31][32][33]. In spite of the high response rate, 18/22 patients died of liver progression in the further course.…”