Combined intermittent dearterialization and intraperitoneal 5-fluorouracil administration for liver tumours in the...

Arterial occlusive therapy in the palliation of liver cancers has gone a long way since the first attempt at hepatic artery ligation. While efforts in permanent hepatic dearterialization have been frustrating in the face of fast developing collaterals, temporary inhibition of hepatic arterial blood flow appears to offer definite advantages. The effect of a single transient hepatic arterial occlusion with and without the addition of intraperitoneal 5FU was tested in Wistar-Furth rats bearing liver tumours. No advantage was observed in terms of tumour growth inhibition unless toxic doses of 5FU were used. A 5-day course of repeated treatment using intermittent dearterialization combined with intraperitoneal 5FU infusion was next tested and was found to be an efficient approach in reducing tumour growth rates. We prefer the intraperitoneal rather than the intraportal route for the infusion of oncolytic drugs because it avoids the problem of portal thrombosis and at the same time deals with any concomitant extrahepatic disease.