The practicality of chronic hepatic artery infusion therapy of primary and metastatic hepatic malignancies: Ten-year results of 124 patients in a prospective protocol

Reed, Melvin L.; Vaitkevicius, Vainutis K.; Al‐Sarraf, Muhyi; Vaughn, Clarence B.; Singhakowinta, Amnuay; Sexon-Porte, Maria; Izbicki, R. M.; Baker, Laurence H.; Straatsma, Glen W.

doi:10.1002/1097-0142(19810115)47:2<402::aid-cncr2820470231>3.0.co;2-b

Cited by 129 publications

(19 citation statements)

References 23 publications

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“…All of these variables may influence the response rate and make it difficult to put this treatment modality into perspective. The overall response rate of 50% in this study is comparable to those obtained in previous studies employing 5-FU or FUDR given by continuous hepatic artery infusion [15][16][17][18][19][20][21][22][23]25271. Survival appears similar, with a twofold increase in responders versus nonresponders.…”

Section: Discussionsupporting

confidence: 84%

“…In a neoplasm where liver involvement is frequent and affects survival, the use of hepatic artery infusion (HAI) has a sound rationale [ 10-141. In the last two decades a number of investigators have reported results of treatment of metastatic colorectal carcinoma employing either prolonged continuous ( 2 21 days) [15][16][17][18][19][20] or short-term ( < 2 1 days) [21-241 infusion with 5-FU or FUDR alone or in combination [25,26] with other chemotherapeutic agents. Response rates have been variable but range from 34% to 73 %, with an average about 50%.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic artery infusion with 5‐fluorouracil and mitomycin‐c in metastatic colorectal carcinoma phase ii study

Theodórs

Bukowski

Lavery

et al. 1982

Med. Pediatr. Oncol.

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Thirty-two patients with hepatic metastases colorectal carcinoma were treated with hepatic artery infusion (HAI) employing 5-fluorouracil (5-FU) and mitomycin-C (mito-C). Catheters were placed percutaneously via the femoral artery. Two schedules were employed: ( I ) 5-FU 1,200 mg/m2 IA (D1-4) and mito-C 8 mg/m2IA (D1 +D4); (2) 5-FU 1,200 mg/m2 IA (Dl-6) and mito-C 8 mg/m2 IA (D1 fD4).Courses were repeated every 4 weeks. Thirty patients with measurable disease were evaluable, 22 received schedule I and 8 patients schedule 11. Complete response occurred in two patients (6.7%) and partial response in 13 patients (43.3%). Five patients (16.7%) had minimal regression. The overall response rate was 66.7%. Median survival of all patients from start of treatment was 11.2 months. Median survival of responders and nonresponders was 12.4 months and 4.6 months, respectively (PcO.05). No differences in response rates, duration of response, or survival was seen between the two schedules. Drug toxicity was moderate to severe, but morbidity of HAI per se was minimal. Intermittent HA1 of 5-FU and mito-C is a well-tolerated treatment modality associated with few serious complications. The response rate, duration of response, and the survival is comparable to continuous HA1 infusion of 5-FU or floxuridine (FUDR). As given in this mdy, mito-C did not appear to provide added benefit.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Hepatic artery infusion with 5‐fluorouracil and mitomycin‐c in metastatic colorectal carcinoma phase ii study

Theodórs

Bukowski

Lavery

et al. 1982

Med. Pediatr. Oncol.

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“…[1][2][3][4] The delivery of drugs directly into an area of the body affected by carcinoma offers several theoretical advantages for improving the efficacy of existing antineoplastic agents. Extensive clinical experience with regional infusion chemotherapy has been reported.…”

Section: Introductionmentioning

confidence: 99%

Patency Rate of Implantable Devices During Long-Term Intraaterial Chemotherapy

et al. 1990

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Intraarterial implantable drug delivery systems have been considered as an alternative method for treating patients with unresectable liver malignancies. However, catheter problems with external implanted devices have resulted in limited application of chemotherapy. The introduction of subcutaneous devices offers an opportunity for long-term locoregional chemotherapy. Twelve external intraarterial catheters were implanted into 12 patients and 52 subcutaneously placed devices into 51 patients, all with various hepatic malignancies. Retrospective analyses comparing those two intraarterial systems were conducted taking into account the function and complication rate (hepatic artery thrombosis, infection, leaking, hemorrhage, and dislocation). The follow-up time for the external system was two to eight months (median five weeks), the thrombosis rate 33.3%, and the infection rate 25%. One instance of severe bleeding from the hepatic artery occurred during chemotherapy. One catheter dislocated. For the subcutaneously implanted intraarterial devices the follow-up time was five to forty-one months (median sixteen months), the thrombotic complication rate 17.3%, and the infection rate 7.6% (all patients with simultaneous bowel surgery). Catheter dislocation one year later required reimplantation; in 1 patient therapy had to be discontinued because of a catheter leak. The overall function rate was 71.3% with a median follow-up time of eight months. Anticoagulation therapy for subcutaneously implanted devices starting from the beginning of intraarterial chemotherapy is recommended to achieve long-term patency. No implantation should be preformed simultaneously with bowel surgery. The subcutaneously placed intraarterial devices had a higher function rate and were available for a longer period as compared with external implanted catheters.

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“…Since the 1960s, there have been numerous reports of infusional therapy for hepatic neoplasms. '3233, 5 The widest experience has been with colorectal carcinoma. An isolated case of metastatic ovarian carcinoma was reported by Scarebelli and Campagnatta. '…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic infusional therapy for metastatic ovarian carcinoma

Malone

Gershenson

Carrasco

et al. 1987

Cancer

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Twenty-four women with ovarian carcinoma that had metastasized to the liver were treated with intrahepatic infusional therapy. No consistent drug regimen was used. There were no complete responders; however, 33% had a partial response. All responses were noticed after the first course of therapy. The median length of response was 6.3 months. The median survival from the time of the first hepatic infusion was 7.5 months for all patients. In this series, there were two treatment-related deaths, one secondary to the chemotherapy, the other to improper catheter placement. Because of the multiplicity of chemotherapy regimens employed, no definite conclusions can be made concerning the efficacy of intrahepatic infusional therapy for metastatic ovarian carcinoma. It is suggested that its future use be restricted to patients with disease limited to the liver and who are being treated according to a study protocol.

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The practicality of chronic hepatic artery infusion therapy of primary and metastatic hepatic malignancies: Ten-year results of 124 patients in a prospective protocol

Cited by 129 publications

References 23 publications

Hepatic artery infusion with 5‐fluorouracil and mitomycin‐c in metastatic colorectal carcinoma phase ii study

Hepatic artery infusion with 5‐fluorouracil and mitomycin‐c in metastatic colorectal carcinoma phase ii study

Patency Rate of Implantable Devices During Long-Term Intraaterial Chemotherapy

Intrahepatic infusional therapy for metastatic ovarian carcinoma

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