Hepatic Arterial Chemotherapy in Combination with Systemic Chemotherapy Compared with Hepatic Arterial Chemotherapy Alone for Liver Metastases from Colorectal Cancer: Results of a Multi-centric Randomized Study
Hepatic arterial infusion (HAI) chemotherapy is accepted to be an option in patients with non-resectable metastases from colorectal cancer confined to the liver. In a multi-istitutional trial, 76 patients were randomly assigned to receive HAI versus HAI plus systemic bolus 5-fluorouracil and leucovo...
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| Veröffentlicht in: | In vivo (Athens) 2006-11, Vol.20 (6A), p.707 |
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| creator | Fiorentini, Giammaria Cantore, Maurizio Rossi, Susanna Vaira, Marco Tumolo, Salvatore Dentico, Patrizia Mambrini, Andrea Bernardeschi, Paolo Turrisi, Gina Giovanis, Petros Guadagni, Stefano Valori, Vanna De Simone, Michele |
| description | Hepatic arterial infusion (HAI) chemotherapy is accepted to be an option in patients with non-resectable metastases from colorectal
cancer confined to the liver. In a multi-istitutional trial, 76 patients were randomly assigned to receive HAI versus HAI
plus systemic bolus 5-fluorouracil and leucovorin. The primary end-point was survival, followed by response, recurrence and
toxicity. Survival was longer for HAI plus systemic chemotherapy (HAI+SYC) than HAI (median, 20 vs. 14 months; p=0.0033),
as were responses (47.5% and 41.7%; p=0.09) and time to hepatic progression (12 vs. 8 months; p=0.039). Side effects included
haematological toxicity that was mostly mild and reversible in 432 cases. Neutropenia grade 3 occurred in four patients in
the HAI+SYC arm and one in the HAI arm. Diarrhoea occurred in 20% and 7% of patients and stomatitis occurred in 18% and 2%,
respectively. On the contrary biliary toxicity was significant; twelve patients had evidence of bilirubin elevations of more
than 3 mg/dl (six in each arm), and two had asymptomatic arterial biliary-tree fistulae: one in the HAI+SYC arm and one in
the HAI arm. Grade 3 elevation in alkaline phosphatase and aminotransferase levels occurred in 26% and 24%, respectively.
In conclusion, the combination of HAI+SYC is active and safe showing a clinical advantage with respect to simple HAI, increasing
overall survival, response rate and time to progression. |
| format | Article |
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cancer confined to the liver. In a multi-istitutional trial, 76 patients were randomly assigned to receive HAI versus HAI
plus systemic bolus 5-fluorouracil and leucovorin. The primary end-point was survival, followed by response, recurrence and
toxicity. Survival was longer for HAI plus systemic chemotherapy (HAI+SYC) than HAI (median, 20 vs. 14 months; p=0.0033),
as were responses (47.5% and 41.7%; p=0.09) and time to hepatic progression (12 vs. 8 months; p=0.039). Side effects included
haematological toxicity that was mostly mild and reversible in 432 cases. Neutropenia grade 3 occurred in four patients in
the HAI+SYC arm and one in the HAI arm. Diarrhoea occurred in 20% and 7% of patients and stomatitis occurred in 18% and 2%,
respectively. On the contrary biliary toxicity was significant; twelve patients had evidence of bilirubin elevations of more
than 3 mg/dl (six in each arm), and two had asymptomatic arterial biliary-tree fistulae: one in the HAI+SYC arm and one in
the HAI arm. Grade 3 elevation in alkaline phosphatase and aminotransferase levels occurred in 26% and 24%, respectively.
In conclusion, the combination of HAI+SYC is active and safe showing a clinical advantage with respect to simple HAI, increasing
overall survival, response rate and time to progression.</description><identifier>ISSN: 0258-851X</identifier><identifier>EISSN: 1791-7549</identifier><identifier>PMID: 17203750</identifier><language>eng</language><publisher>Greece: International Institute of Anticancer Research</publisher><subject>Antimetabolites, Antineoplastic - administration & dosage ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - pathology ; Drug Combinations ; Floxuridine - administration & dosage ; Fluorouracil - administration & dosage ; Hepatic Artery ; Humans ; Injections, Intra-Arterial ; Injections, Intravenous ; Leucovorin - administration & dosage ; Liver Neoplasms - drug therapy ; Liver Neoplasms - mortality ; Liver Neoplasms - secondary ; Survival Rate ; Treatment Outcome</subject><ispartof>In vivo (Athens), 2006-11, Vol.20 (6A), p.707</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17203750$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fiorentini, Giammaria</creatorcontrib><creatorcontrib>Cantore, Maurizio</creatorcontrib><creatorcontrib>Rossi, Susanna</creatorcontrib><creatorcontrib>Vaira, Marco</creatorcontrib><creatorcontrib>Tumolo, Salvatore</creatorcontrib><creatorcontrib>Dentico, Patrizia</creatorcontrib><creatorcontrib>Mambrini, Andrea</creatorcontrib><creatorcontrib>Bernardeschi, Paolo</creatorcontrib><creatorcontrib>Turrisi, Gina</creatorcontrib><creatorcontrib>Giovanis, Petros</creatorcontrib><creatorcontrib>Guadagni, Stefano</creatorcontrib><creatorcontrib>Valori, Vanna</creatorcontrib><creatorcontrib>De Simone, Michele</creatorcontrib><title>Hepatic Arterial Chemotherapy in Combination with Systemic Chemotherapy Compared with Hepatic Arterial Chemotherapy Alone for Liver Metastases from Colorectal Cancer: Results of a Multi-centric Randomized Study</title><title>In vivo (Athens)</title><addtitle>In Vivo</addtitle><description>Hepatic arterial infusion (HAI) chemotherapy is accepted to be an option in patients with non-resectable metastases from colorectal
cancer confined to the liver. In a multi-istitutional trial, 76 patients were randomly assigned to receive HAI versus HAI
plus systemic bolus 5-fluorouracil and leucovorin. The primary end-point was survival, followed by response, recurrence and
toxicity. Survival was longer for HAI plus systemic chemotherapy (HAI+SYC) than HAI (median, 20 vs. 14 months; p=0.0033),
as were responses (47.5% and 41.7%; p=0.09) and time to hepatic progression (12 vs. 8 months; p=0.039). Side effects included
haematological toxicity that was mostly mild and reversible in 432 cases. Neutropenia grade 3 occurred in four patients in
the HAI+SYC arm and one in the HAI arm. Diarrhoea occurred in 20% and 7% of patients and stomatitis occurred in 18% and 2%,
respectively. On the contrary biliary toxicity was significant; twelve patients had evidence of bilirubin elevations of more
than 3 mg/dl (six in each arm), and two had asymptomatic arterial biliary-tree fistulae: one in the HAI+SYC arm and one in
the HAI arm. Grade 3 elevation in alkaline phosphatase and aminotransferase levels occurred in 26% and 24%, respectively.
In conclusion, the combination of HAI+SYC is active and safe showing a clinical advantage with respect to simple HAI, increasing
overall survival, response rate and time to progression.</description><subject>Antimetabolites, Antineoplastic - administration & dosage</subject><subject>Colorectal Neoplasms - drug therapy</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Drug Combinations</subject><subject>Floxuridine - administration & dosage</subject><subject>Fluorouracil - administration & dosage</subject><subject>Hepatic Artery</subject><subject>Humans</subject><subject>Injections, Intra-Arterial</subject><subject>Injections, Intravenous</subject><subject>Leucovorin - administration & dosage</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - secondary</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0258-851X</issn><issn>1791-7549</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kNFKwzAUhosobk5fQXLjZSFtlqb1rgx1woawKXhX0uTERtqmJNlGfUyfyMj0whvhwDkX3__9cE6iacKKJGZ0XpxGU5zSPM5p8jqJLpx7xzhjGKfn0SRhKSaM4mn0uYSBey1QaT1YzVu0aKAzvgHLhxHpHi1MV-s-MKZHB-0btB2dhy5E_pABG7gFeWT-t5at6QEpY9FK78GiNXjuwoBDypouuFpjQfjvHO8F2Fu0AbdrvUNGIY7W4dSxgN7b0LHhvTSd_gjdW7-T42V0pnjr4Opnz6KX-7vnxTJePT08LspV3KSk8LHIKRdpmpEcMsYoIxxkzeZZktUkL0TBGMeqxiLJoZAyk0lNQSrKZKFUkeOMzKLro3fY1R3IarC643asfp8bgJsj0Oi35qAtVK7jbRtwUul9iqusrBhm5Aulyom2</recordid><startdate>20061101</startdate><enddate>20061101</enddate><creator>Fiorentini, Giammaria</creator><creator>Cantore, Maurizio</creator><creator>Rossi, Susanna</creator><creator>Vaira, Marco</creator><creator>Tumolo, Salvatore</creator><creator>Dentico, Patrizia</creator><creator>Mambrini, Andrea</creator><creator>Bernardeschi, Paolo</creator><creator>Turrisi, Gina</creator><creator>Giovanis, Petros</creator><creator>Guadagni, Stefano</creator><creator>Valori, Vanna</creator><creator>De Simone, Michele</creator><general>International Institute of Anticancer Research</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20061101</creationdate><title>Hepatic Arterial Chemotherapy in Combination with Systemic Chemotherapy Compared with Hepatic Arterial Chemotherapy Alone for Liver Metastases from Colorectal Cancer: Results of a Multi-centric Randomized Study</title><author>Fiorentini, Giammaria ; Cantore, Maurizio ; Rossi, Susanna ; Vaira, Marco ; Tumolo, Salvatore ; Dentico, Patrizia ; Mambrini, Andrea ; Bernardeschi, Paolo ; Turrisi, Gina ; Giovanis, Petros ; Guadagni, Stefano ; Valori, Vanna ; De Simone, Michele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h239t-c85ac22638e677573aedb74616b389c977a0fb0c18e9dd6d1b5edf57d9ff98063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Antimetabolites, Antineoplastic - administration & dosage</topic><topic>Colorectal Neoplasms - drug therapy</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Drug Combinations</topic><topic>Floxuridine - administration & dosage</topic><topic>Fluorouracil - administration & dosage</topic><topic>Hepatic Artery</topic><topic>Humans</topic><topic>Injections, Intra-Arterial</topic><topic>Injections, Intravenous</topic><topic>Leucovorin - administration & dosage</topic><topic>Liver Neoplasms - drug therapy</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - secondary</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fiorentini, Giammaria</creatorcontrib><creatorcontrib>Cantore, Maurizio</creatorcontrib><creatorcontrib>Rossi, Susanna</creatorcontrib><creatorcontrib>Vaira, Marco</creatorcontrib><creatorcontrib>Tumolo, Salvatore</creatorcontrib><creatorcontrib>Dentico, Patrizia</creatorcontrib><creatorcontrib>Mambrini, Andrea</creatorcontrib><creatorcontrib>Bernardeschi, Paolo</creatorcontrib><creatorcontrib>Turrisi, Gina</creatorcontrib><creatorcontrib>Giovanis, Petros</creatorcontrib><creatorcontrib>Guadagni, Stefano</creatorcontrib><creatorcontrib>Valori, Vanna</creatorcontrib><creatorcontrib>De Simone, Michele</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>In vivo (Athens)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fiorentini, Giammaria</au><au>Cantore, Maurizio</au><au>Rossi, Susanna</au><au>Vaira, Marco</au><au>Tumolo, Salvatore</au><au>Dentico, Patrizia</au><au>Mambrini, Andrea</au><au>Bernardeschi, Paolo</au><au>Turrisi, Gina</au><au>Giovanis, Petros</au><au>Guadagni, Stefano</au><au>Valori, Vanna</au><au>De Simone, Michele</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatic Arterial Chemotherapy in Combination with Systemic Chemotherapy Compared with Hepatic Arterial Chemotherapy Alone for Liver Metastases from Colorectal Cancer: Results of a Multi-centric Randomized Study</atitle><jtitle>In vivo (Athens)</jtitle><addtitle>In Vivo</addtitle><date>2006-11-01</date><risdate>2006</risdate><volume>20</volume><issue>6A</issue><spage>707</spage><pages>707-</pages><issn>0258-851X</issn><eissn>1791-7549</eissn><abstract>Hepatic arterial infusion (HAI) chemotherapy is accepted to be an option in patients with non-resectable metastases from colorectal
cancer confined to the liver. In a multi-istitutional trial, 76 patients were randomly assigned to receive HAI versus HAI
plus systemic bolus 5-fluorouracil and leucovorin. The primary end-point was survival, followed by response, recurrence and
toxicity. Survival was longer for HAI plus systemic chemotherapy (HAI+SYC) than HAI (median, 20 vs. 14 months; p=0.0033),
as were responses (47.5% and 41.7%; p=0.09) and time to hepatic progression (12 vs. 8 months; p=0.039). Side effects included
haematological toxicity that was mostly mild and reversible in 432 cases. Neutropenia grade 3 occurred in four patients in
the HAI+SYC arm and one in the HAI arm. Diarrhoea occurred in 20% and 7% of patients and stomatitis occurred in 18% and 2%,
respectively. On the contrary biliary toxicity was significant; twelve patients had evidence of bilirubin elevations of more
than 3 mg/dl (six in each arm), and two had asymptomatic arterial biliary-tree fistulae: one in the HAI+SYC arm and one in
the HAI arm. Grade 3 elevation in alkaline phosphatase and aminotransferase levels occurred in 26% and 24%, respectively.
In conclusion, the combination of HAI+SYC is active and safe showing a clinical advantage with respect to simple HAI, increasing
overall survival, response rate and time to progression.</abstract><cop>Greece</cop><pub>International Institute of Anticancer Research</pub><pmid>17203750</pmid></addata></record> |
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| ispartof | In vivo (Athens), 2006-11, Vol.20 (6A), p.707 |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Antimetabolites, Antineoplastic - administration & dosage Colorectal Neoplasms - drug therapy Colorectal Neoplasms - mortality Colorectal Neoplasms - pathology Drug Combinations Floxuridine - administration & dosage Fluorouracil - administration & dosage Hepatic Artery Humans Injections, Intra-Arterial Injections, Intravenous Leucovorin - administration & dosage Liver Neoplasms - drug therapy Liver Neoplasms - mortality Liver Neoplasms - secondary Survival Rate Treatment Outcome |
| title | Hepatic Arterial Chemotherapy in Combination with Systemic Chemotherapy Compared with Hepatic Arterial Chemotherapy Alone for Liver Metastases from Colorectal Cancer: Results of a Multi-centric Randomized Study |
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