HEPATIC ARTERIAL BOLUS CHEMOTHERAPY FOR COLORECTAL METASTASES USING AN IMPLANTABLE PORT - A NEGATIVE INFLUENCE OF PREVIOUS SYSTEMIC TREATMENT

Twenty-one patients with isolated colorectal liver metastases underwen t hepatic artery infusion (HAI) port implantation for regional chemoth erapy with bolus injections of 5-FU, LV and fast drip of cisplatin. Te n of the 21 patients had previously failed systemic chemotherapy befor e HAI. Toxicity was moderate and no need for modulation of the chemoth erapeutic dose was required. The objective response rate of the whole group was 52.4%. The patients, who had not previously received systemi c chemotherapy, had a significantly higher response rate of 81.8% comp ared to patients treated previously by systemic chemotherapy, who had a response rate of 20% (p=0.0089). In addition, there was a difference in cumulative survival between these two groups. The HAI combined che motherapy with 5-FU, LV and cisplatin given by bolus injection through an implantable port is effective therapy with similar response rate b ut considerable reduced toxicity compared to continuous HAI with FUdR. We assume that this therapy might prolong survival significantly espe cially in patients not treated before by systemic chemotherapy.