TREATMENT OF PATIENTS WITH IRRESECTABLE LIVER METASTASES FROM COLORECTAL-CANCER BY CHEMO-OCCLUSION WITH DEGRADABLE STARCH MICROSPHERES

Chemo-occlusion of the liver increases the tumour concentration of dru gs. Thirty-nine patients with colorectal liver metastases received a m onthly bolus administration of mitomycin C (10 mg/m(2) on day 1) plus a continuous infusion of 5-fluorouracil (500 mg/m(2) daily from days 1 to 5). Drugs were given via both portal (one-third of the dose) and a rterial (two-thirds) routes to control large and small metastases. Art erially administered mitomycin C was mixed with individualized doses o f degradable starch microspheres. In 16 patients treatment was not sta rted or was interrupted early because of arterial or portal catheter p roblems. In 23 patients who received two or more cycles of treatment t he mean(s.d.) microsphere dose was 835(399) mg. Toxicity was mild, con sisting mainly of pain. Five complete and five partial responses were seen, and six patients had stable disease. The median time to progress ion and length of survival were 6 and 16 months respectively. The rela tively high rates of complete and overall response in hypovascular tum ours (six of 12 lesions) may support the rationale of chemo-occlusion,