PURPOSE: This study was designed to determine if hepatic arterial therapy with floxuridine (F), mitomycin, and carmustine (BCNU) (FMB) is superior to hepatic arterial therapy with F alone in previously treated patients with hepatic metastases from colorectal cancer. PATIENTS AND METHODS: Ninety-five patients were randomized to intrahepatic FMB versus intrahepatic F. All patients had tumor progression after systemic chemotherapy (either therapeutic or adjuvant). RESULTS: There was no significant difference in response rate (47% FMB v 33% F; P = .17). Median survival was similar in the two groups, 19.1 months for the FMB group compared with 14.0 months for the F group (P = .23). The overall median survival was 16.8 months. In patients who received prior adjuvant therapy, there was no difference between the two groups, but response rate was high in both (50% FMB v 62% F). The response rate for all patients who had received only prior adjuvant therapy versus all those who had received prior therapy for metastatic disease was 57% and 35%, respectively (P = .066). In the subset of patients whose disease had progressed with prior systemic chemotherapy, the response rate to FMB was greater than that to F (47% v 23%; P = .035). CONCLUSION: The overall partial response rate of 39% and the overall survival of 16.8 months from initiation of intrahepatitis therapy show that hepatic arterial therapy is a reasonable treatment option for patients whose tumor does not respond to systemic therapy or whose disease progresses after adjuvant therapy for colorectal cancer.
RCT Entities:
PURPOSE: This study was designed to determine if hepatic arterial therapy with floxuridine (F), mitomycin, and carmustine (BCNU) (FMB) is superior to hepatic arterial therapy with F alone in previously treated patients with hepatic metastases from colorectal cancer. PATIENTS AND METHODS: Ninety-five patients were randomized to intrahepatic FMB versus intrahepatic F. All patients had tumor progression after systemic chemotherapy (either therapeutic or adjuvant). RESULTS: There was no significant difference in response rate (47% FMB v 33% F; P = .17). Median survival was similar in the two groups, 19.1 months for the FMB group compared with 14.0 months for the F group (P = .23). The overall median survival was 16.8 months. In patients who received prior adjuvant therapy, there was no difference between the two groups, but response rate was high in both (50% FMB v 62% F). The response rate for all patients who had received only prior adjuvant therapy versus all those who had received prior therapy for metastatic disease was 57% and 35%, respectively (P = .066). In the subset of patients whose disease had progressed with prior systemic chemotherapy, the response rate to FMB was greater than that to F (47% v 23%; P = .035). CONCLUSION: The overall partial response rate of 39% and the overall survival of 16.8 months from initiation of intrahepatitis therapy show that hepatic arterial therapy is a reasonable treatment option for patients whose tumor does not respond to systemic therapy or whose disease progresses after adjuvant therapy for colorectal cancer.
Authors: Adam C Yopp; Lawrence H Schwartz; Nancy Kemeny; David H Gultekin; Mithat Gönen; Zubin Bamboat; Jinru Shia; Dana Haviland; Michael I D'Angelica; Yuman Fong; Ronald P DeMatteo; Peter J Allen; William R Jarnagin Journal: Ann Surg Oncol Date: 2011-02-01 Impact factor: 5.344
Authors: Simone Mocellin; Zora Baretta; Marta Roqué I Figuls; Ivan Solà; Marta Martin-Richard; Sara Hallum; Xavier Bonfill Cosp Journal: Cochrane Database Syst Rev Date: 2017-01-27
Authors: G Fiorentini; D B Poddie; U De Giorgi; D Guglielminetti; P Giovanis; M Leoni; W Latino; C Dazzi; A Cariello; D Turci; M Marangolo Journal: Med Oncol Date: 2000-08 Impact factor: 3.064
Authors: Ergül Eyol; Annemarie Boleij; Rachel R Taylor; Andrew L Lewis; Martin R Berger Journal: Clin Exp Metastasis Date: 2008-02-08 Impact factor: 5.150