ARTERIAL THERAPY OF HEPATIC COLORECTAL METASTASES

Considerable experience of the treatment of irresectable hepatic color ectal metastases has accumulated over the past three decades. In this review, the rational for hepatic artery treatment of colorectal metast ases to the liver is presented and various access techniques and chemo therapeutic agents for infusion are discussed. Randomized trials of he patic artery chemotherapy (HAC) are analysed, and the promising result s of recent studies combining less toxic and more effective agents are summarized. Continuous infusion pumps provide the most reliable and l ong-lasting access for HAC. Appropriate surgical techniques and medica l management can minimize complications. Although tumour progression i s best controlled by HAC, a clear-cut survival advantage has yet to be demonstrated. While hepatic artery infusion chemotherapy cannot yet b e recommended outside investigational protocols, the experience gained so far should stimulate further studies.