SUPERSELECTIVE INTRAARTERIAL CHEMOTHERAPY WITH MITOMYCIN-C IN HEPATICMETASTASES FROM COLORECTAL-CANCER

Background: Mitomycin C has been found clinically useful in the treatm ent of colorectal cancer when administered via the hepatic artery. In a prospective therapeutic trial, we studied the effect of superselecti ve intraarterial chemotherapy with mitomycin C in patients with hepati c metastases from colorectal cancer. Methods: Forty-six patients with hepatic metastases from colorectral cancer received intra-arterial che motherapy with mitomycin C (SIAC) between 1981 and 1991. The results o f a 5-year follow-up were compared with 46 control patients standardiz ed by sex, age, and tumor distribution. Results: The overall response rate to intra-arterial chemotherapy was 20%. The median survival time for responders was 26 months and that for nonresponders 12 months (P < 0.003). The median survival period after intra-arterial chemotherapy was 15 months, compared with 9 months in controls (P < 0.004). The cum ulative 5-year survival rate was 6% for patients treated by SIAC and 5 % for controls. Cessation of chemotherapy was necessary in 39 of the 4 6 patients: in 28 because of tumor progression, in 9 because of toxici ty, in 1 because of catheterization difficulties, and in 1 because of patient refusal. Conclusions: Superselective intra-arterial mitomycin C therapy had a poor effect on hepatic metastases from colorectal canc er because of the low response and long-term survival rates. (C) 1997 Wiley-Liss, Inc.