Clinical results of pharmacokinetic modulating chemotherapy (PMC) in combination with hepatic arterial 5FU infusion, continuous venous 5FU infusion and oral UFT as adjuvant chemotherapy after liver resection for hepatic colorectal metastases

Abstract

3665 Background: We have presented the usefulness of pharmacokinetic modulating chemotherapy in combination with hepatic arterial 5FU infusion and oral UFT (HAI-PMC) as adjuvant chemotherapy after liver resection for hepatic colorectal metastases before. (ASCO Abst 556,2001) We also assessed the usefulness of PMC in combination with continuous venous 5FU infusion and oral UFT (CVI-PMC) as adjuvant chemotherapy for Dukes C colorectal cancer. (ASCO Abst 1175,2003) To decrease the recurrent rate at extrahepatic sites and improve prognosis we instituted PMC in combination with hepatic arterial 5FU infusion, continuous venous 5FU infusion and oral UFT as adjuvant chemotherapy after liver resection for hepatic colorectal metastases. Methods: Fifty-nine patients were randomly divided into 2 groups after liver resection. Group A (n=30 patients), underwent HAI-PMC in a combination of intra-arterial infusion of 5FU for 2 consecutive days per week at 600mg/m2/day and oral administration of UFT at 400mg/day for 5 days per week for 3 months. Group B (n=29), underwent CVI-PMC in a combination of continuous venous 5FU infusion per week at 600mg/m2/day and oral administration of UFT at 400mg/day for 5 to 7 days per week for 12 months after finishing HAI-PMC. Results: The five-year survival rate of patients in the A group was 61%, and in the B group 63%.(p=0.98) The five-year recurrence rate in remnant liver after hepatic resection was 12% and 11%, respectively (p=0.82); and the rate of extrahepatic recurrence was 38.1% and 34.6%, respectively (P-0.56). Conclusions: It is thought that further intensive systemic chemotherapy is necessary to decrease the rate of extrahepatic recurrence and improve prognosis. No significant financial relationships to disclose.