Hepatic artery infusion with raltitrexed or 5-fluorouracil for colorectal cancer liver metastasis

World J Gastroenterol. 2017 Feb 28;23(8):1406-1411. doi: 10.3748/wjg.v23.i8.1406.

Abstract

Aim: To evaluate the efficiency and safety of hepatic artery infusion chemotherapy (HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer (CRC) liver metastasis (CRCLM).

Methods: A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed.

Results: The median survival time (MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed (TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil (FOLFOX) arm (P = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm (P = 0.734). Median progression-free survival (PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm (P = 0.215). Leukopenia (P = 0.026) was more common in the FOLFOX arm, and hepatic disorder (P = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.

Conclusion: No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.

Keywords: Colorectal cancer; FOLFOX; Hepatic artery infusion chemotherapy; Liver metastasis; Raltitrexed.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / secondary
  • Female
  • Fluorouracil / administration & dosage*
  • Hepatic Artery / surgery*
  • Humans
  • Infusions, Intra-Arterial
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Quinazolines / administration & dosage*
  • Retrospective Studies
  • Thiophenes / administration & dosage*
  • Time Factors
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Quinazolines
  • Thiophenes
  • Oxaliplatin
  • raltitrexed
  • Fluorouracil