Hepatic Arterial Infusion with Irinotecan, Oxaliplatin, and Floxuridine plus Systemic Chemotherapy as First-Line Treatment of Unresectable Liver Metastases from Colorectal Cancer

Abstract

Background: The aim of this study was to evaluate the therapeutic efficacy and safety of hepatic arterial infusion (HAI) with irinotecan, oxaliplatin, and floxuridine as a firstline treatment in patients with unresectable liver metastases of colorectal cancer (CRC). Patients and Methods: Individual patients were treated with irinotecan (120 mg/m²), oxaliplatin (100 mg/m²), and floxuridine (500 mg/m²) via tumorsupplying arteries. Intravenous leucovorin (200 mg/day) and floxuridine (300 mg/m²/day) were given on days 1–3 after the procedure. The therapeutic courses were repeated every 4–8 weeks. Tumor responses, overall survival, and the time to tumor progression were observed. Results: 204 cumulative cycles of chemotherapy were performed for 31 patients (median 7.0). 19 patients achieved a partial response; in 10 patients the disease stabilized, and in 2 patients the disease progressed, producing an overall response rate of 61.3%. The median survival time was 24.8 months, and the median time to tumor progression was 10.1 months. Frequencies of grade 3–4 neutropenia, diarrhea, elevation of serum bilirubin, elevation of serum transaminases, and vomiting were 6.5, 9.7, 3.2, 19.4, and 90.3%, respectively. Conclusion: This triplecombination chemotherapy as firstline treatment through HAI was well tolerated and effective in patients with unresectable liver metastases of CRC.