Hepatic artery infusion chemotherapy with the Infusaid pump: a Canadian experience

Hepatic artery infusion of 5-fluoro-2'-deoxyuridine (FUDR), utilizing the implantable "Infusaid pump", was used to treat 16 patients with diffuse hepatic metastases from colorectal carcinoma. Pump implantation was associated with minimal morbidity and no deaths. The pumps have now been in use for 190 treatment-months without serious complication. Six patients died of cancer between 3 and 26 months (mean 13 months) after insertion of the pump. Five died with recurrent disease outside the liver. Ten patients were alive 6 to 17 months (mean 12 months) after pump implantation. Follow-up ultrasonography in 13 patients documented regression of hepatic lesions in 7, no change in 4 and progression in 2. Regional perfusion chemotherapy can be instituted safely and treatment carries acceptable morbidity. Survival is prolonged relative to historic controls. Death ultimately occurs because of distant metastases. True assessment of the efficacy of this therapy demands prospective randomized trials of regional perfusion versus conventional therapy, with care to incorporate objective means of assessing quality of life during treatment.