Hepatic artery infusion chemotherapy for colorectal metastases: a personal experience

A personal experience is reported with hepatic artery infusion (HAI) chemotherapy of 57 patients with metastatic colorectal carcinoma confined to the liver. Fifty-seven percent of the 54 patients who received more than 2 weeks of infusion had objective regressions documented on hepatic scans. The response rate with fluorouracil and mitomycin C (75%) was higher than for fluorouracil alone (52.5%). The median survival of treated patients was 15 months with the longest survivor living 3 years 8 months, and responders had a median survival 3 months longer than nonresponders. Complications included one case of hemolytic uremic syndrome after HAI with mitomycin C. Survival after HAI was 9 months longer than that of comparable historical controls who received no treatment, but survival after HAI with fluorouracil alone was not superior to that of comparable patients treated with intravenous fluorouracil. HAI produces a high frequency of tumor regression, but superior survival has yet to be demonstrated.