Feasibility of adjuvant hepatic arterial infusion of chemotherapy after radiofrequency ablation with or without resection in patients with hepatic metastases from colorectal cancer |
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Authors: | Scaife Courtney L Curley Steven A Izzo Francesco Marra Paolo Delrio Paolo Daniele Bruno Cremona Franco Gershenwald Jeffrey E Chase Judy L Lozano Richard D Patt Yehuda Z Fornage Bruno D Vauthey Jean Nicolas Woodall Misty L Gonzalez Karen B Ellis Lee M |
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Affiliation: | (1) Departments of Surgical Oncology, The University of Texas, M. D. Anderson Cancer Center, Houston, Texas;(2) Gastrointestinal Medical Oncology, The University of Texas, M. D. Anderson Cancer Center, Houston, Texas;(3) Departments of Diagnostic Radiology, The University of Texas, M. D. Anderson Cancer Center, Houston, Texas;(4) Departments of Division of Pharmacy, The University of Texas, M. D. Anderson Cancer Center, Houston, Texas;(5) Department of Surgery, G. Pascale National Tumor Institute, Naples, Italy;(6) Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 444, Houston, TX, 77030-4009 |
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Abstract: | Background: The safety of combined hepatic artery infusion chemotherapy (HAI) and radiofrequency ablation (RFA) for liver metastases has not been assessed. We conducted a study to determine the feasibility of using HAI after RFA for colorectal cancer (CRC) liver metastases.Methods: Between 1996 and 2001, patients with hepatic metastases from CRC were enrolled onto a prospective study of RFA plus HAI consisting of continuous-infusion floxuridine and bolus fluorouracil. Surgical complications, treatment-related toxicities, and patient outcomes were recorded.Results: Fifty patients were treated with RFA and HAI with or without resection. A median of two lesions per patient, with a median greatest diameter of 2.0 cm, were treated with RFA. Postoperative complications, including 1 death, occurred in 11 of 50 patients. Toxicity from HAI was relatively mild. At 20 months median follow-up, 32% of patients remained disease free. Ten percent of patients had recurrences at the site of RFA, 30% developed new liver metastases, and 48% developed extrahepatic disease.Conclusions:RFA of CRC liver metastases followed by HAI is feasible and is associated with acceptable complication and toxicity rates. The high rate of disease recurrence in our patients indicates that novel combinations of regional and systemic therapies are needed to improve patient outcomes. |
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Keywords: | Radiofrequency ablation Hepatic artery infusion Colorectal cancer Hepatic metastases |
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