Combination cancer chemotherapy by regional intra-arterial or intra-aortic infusion of 5-fluorouracil and mitomycin-C with or without irradiation.

Abstract

In conclusion the combination cancer chemotherapy with intra-arterial or intra-aortic infusion of 5-FU and MMC with or without irradiation has proved of great value in the treatment of unresectable or recurrent cancer and offered selected patients significant palliation (Table 1). In our studies of the patients with advanced head and neck cancer unsuitable for conventional surgery, 68% of the patients showed regression with intra-arterial infusion of 5-FU and MMC with or without irradiation. In 38 evaluable patients with primary and metastatic liver tumors and pancreatic cancer, 71% of the patients showed objective evidence of response following hepatic artery infusion of 5-FU and MMC. Survival with this treatment for approximately 6 months was achieved in 53% of the patients so treated and 20% survival rate was achieved at the 12 month point. Objective tumor response was noted in 53% of the patients with pulmonary and gastrointestinal tract cancer by regional intra-aortic subselective infusion of 5-FU and MMC with or without irradiation. Analysis showed that 40% of the evaluable patients with lung cancer, 57% of the patients with stomach cancer, and 47% of the patients with colorectal cancer respectively demonstrated positive response to this therapy. The patients with unresectable colorectal cancer showed 50% survival rate at 12 month point after start of treatment with an average survival of 12.9 months. In 67 of over all 109 evaluable patients (61%) so treated the results has been good in terms of objective tumor regression and they sustained transient clinical benefits. Forty two of the 109 evaluable patients were classified as unimproved. Forty-three patients were un-evaluable since either the patient failed to complete the therapeutic regimen according to the protocol or the primary tumor was resected before starting the infusion chemotherapy or the patient was recent case before evaluation. Our results suggest that far advanced, non-resectable local malignancies without demonstrable distant metastasis should be treated vigorously with combined intra-arterial or intra-aortic infusion chemotherapy of 5-FU and MMC and irradiation.