Hepatic intraarterial chemotherapy--current status and future prospects--"If you have a short sword, take a step...

The use of hepatic intraarterial (IA) chemotherapy for patients with unresectable liver malignancy has become an increasingly popular mode of therapy. Advances in the understanding of antineoplastic pharmacology, catheter placement technique, and infusion pump design have renewed interest in this approach. Despite inadequacies of the historical data, it appears that IA therapy may be superior to conventional intravenous therapy for patients who have disease limited to the liver, especially from colorectal and hepatocellular malignancies. Unanswered are questions concerning which is the best drug (or drugs) for IA therapy, how to properly integrate IA therapy with surgery and radiation, and how to select patients likely to respond. This renovated technology offers a bright promise for the future of clinical oncology.