Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1997;76(10):1390–1393. doi: 10.1038/bjc.1997.566

A phase II study of regional 2-weekly 5-fluorouracil infusion with intravenous folinic acid in the treatment of colorectal liver metastases.

J D Howell 1, C S McArdle 1, D J Kerr 1, J Buckles 1, J A Ledermann 1, I Taylor 1, H J Gallagher 1, J Budden 1
PMCID: PMC2228150  PMID: 9374389

Abstract

Forty patients with unresectable colorectal metastases confined to the liver were evaluated in a phase II study. 5-Fluorouracil (5-FU) was delivered via a surgically placed hepatic artery catheter. Patients received folinic acid (200 mg m-2) intravenously over 2 h followed by a loading dose of intra-arterial 5-FU (400 mg m-2) over 15 min, then 5-FU (1600 mg m-2) by intra-arterial infusion over the following 22 h. This was repeated on day 2 and the whole schedule was repeated every 2 weeks. Response was assessed after six treatments. The median follow-up was 17 months. Overall response rate was 46% with 8% complete response. Estimated median survival is 19 months. Site of progression was the liver alone in 55%, liver and lung in another 16% and 29% in other sites. Eight patients experienced grade 3 or 4 toxicity. The response rate of this regimen compares favourably with reported trials of intra-arterial FUDR, and our schedule is currently being compared with a similar schedule of intravenous 5-FU and folinic acid in a randomized Medical Research Council trial (CR05).

Full text

PDF
1390

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen-Mersh T. G., Earlam S., Fordy C., Abrams K., Houghton J. Quality of life and survival with continuous hepatic-artery floxuridine infusion for colorectal liver metastases. Lancet. 1994 Nov 5;344(8932):1255–1260. doi: 10.1016/s0140-6736(94)90750-1. [DOI] [PubMed] [Google Scholar]
  2. Anderson J. H., Goldberg J. A., Leiberman D. P., Stewart I., Cooke T. G., McArdle C. S. Saphenous vein grafts for anatomical variations encountered at surgical insertion of a hepatic artery catheter. Eur J Surg Oncol. 1992 Oct;18(5):484–486. [PubMed] [Google Scholar]
  3. BREEDIS C., YOUNG G. The blood supply of neoplasms in the liver. Am J Pathol. 1954 Sep-Oct;30(5):969–977. [PMC free article] [PubMed] [Google Scholar]
  4. Blijham G., Wagener T., Wils J., de Greve J., Buset M., Bleiberg H., Lacave A., Dalmark M., Selleslag J., Collette L. Modulation of high-dose infusional fluorouracil by low-dose methotrexate in patients with advanced or metastatic colorectal cancer: final results of a randomized European Organization for Research and Treatment of Cancer Study. J Clin Oncol. 1996 Aug;14(8):2266–2273. doi: 10.1200/JCO.1996.14.8.2266. [DOI] [PubMed] [Google Scholar]
  5. De Gramont A., Krulik M., Cady J., Lagadec B., Maisani J. E., Loiseau J. P., Grange J. D., Gonzalez-Canali G., Demuynck B., Louvet C. High-dose folinic acid and 5-fluorouracil bolus and continuous infusion in advanced colorectal cancer. Eur J Cancer Clin Oncol. 1988 Sep;24(9):1499–1503. doi: 10.1016/0277-5379(88)90341-0. [DOI] [PubMed] [Google Scholar]
  6. Gamelin E. C., Danquechin-Dorval E. M., Dumesnil Y. F., Maillart P. J., Goudier M. J., Burtin P. C., Delva R. G., Lortholary A. H., Gesta P. H., Larra F. G. Relationship between 5-fluorouracil (5-FU) dose intensity and therapeutic response in patients with advanced colorectal cancer receiving infusional therapy containing 5-FU. Cancer. 1996 Feb 1;77(3):441–451. doi: 10.1002/(SICI)1097-0142(19960201)77:3<441::AID-CNCR4>3.0.CO;2-N. [DOI] [PubMed] [Google Scholar]
  7. Hohn D. C., Stagg R. J., Friedman M. A., Hannigan J. F., Jr, Rayner A., Ignoffo R. J., Acord P., Lewis B. J. A randomized trial of continuous intravenous versus hepatic intraarterial floxuridine in patients with colorectal cancer metastatic to the liver: the Northern California Oncology Group trial. J Clin Oncol. 1989 Nov;7(11):1646–1654. doi: 10.1200/JCO.1989.7.11.1646. [DOI] [PubMed] [Google Scholar]
  8. Howell J. D., Gallagher H., Kane E., Maguire R., McArdle C. S. Infusion pumps for systemic and intra-arterial chemotherapy of colorectal liver metastases. Ann R Coll Surg Engl. 1997 Jul;79(4):257–258. [PMC free article] [PubMed] [Google Scholar]
  9. Kemeny M. M., Goldberg D., Beatty J. D., Blayney D., Browning S., Doroshow J., Ganteaume L., Hill R. L., Kokal W. A., Riihimaki D. U. Results of a prospective randomized trial of continuous regional chemotherapy and hepatic resection as treatment of hepatic metastases from colorectal primaries. Cancer. 1986 Feb 1;57(3):492–498. doi: 10.1002/1097-0142(19860201)57:3<492::aid-cncr2820570315>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  10. Kemeny N., Daly J., Reichman B., Geller N., Botet J., Oderman P. Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma. A randomized trial. Ann Intern Med. 1987 Oct;107(4):459–465. doi: 10.7326/0003-4819-107-4-459. [DOI] [PubMed] [Google Scholar]
  11. Kerr D. J., Ledermann J. A., McArdle C. S., Buckels J., Neoptolemos J., Seymour M., Doughty J., Budden J., Taylor I. Phase I clinical and pharmacokinetic study of leucovorin and infusional hepatic arterial fluorouracil. J Clin Oncol. 1995 Dec;13(12):2968–2972. doi: 10.1200/JCO.1995.13.12.2968. [DOI] [PubMed] [Google Scholar]
  12. Martin J. K., Jr, O'Connell M. J., Wieand H. S., Fitzgibbons R. J., Jr, Mailliard J. A., Rubin J., Nagorney D. M., Tschetter L. K., Krook J. E. Intra-arterial floxuridine vs systemic fluorouracil for hepatic metastases from colorectal cancer. A randomized trial. Arch Surg. 1990 Aug;125(8):1022–1027. doi: 10.1001/archsurg.1990.01410200086013. [DOI] [PubMed] [Google Scholar]
  13. Rougier P., Laplanche A., Huguier M., Hay J. M., Ollivier J. M., Escat J., Salmon R., Julien M., Roullet Audy J. C., Gallot D. Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial. J Clin Oncol. 1992 Jul;10(7):1112–1118. doi: 10.1200/JCO.1992.10.7.1112. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES