Quality of life and survival with continuous hepatic-artery floxuridine infusion for colorectal liver metastases

@article{AllenMersh1994QualityOL,
  title={Quality of life and survival with continuous hepatic-artery floxuridine infusion for colorectal liver metastases},
  author={Timothy G. Allen-Mersh and S. Earlam and Carol Fordy and K R Abrams and J. Houghton},
  journal={The Lancet},
  year={1994},
  volume={344},
  pages={1255-1260}
}
Hepatic arterial infusion of irinotecan, 5-Fluorouracil and leucovorin in patients with liver metastases from colorectal carcinoma.
TLDR
The data demonstrate the efficacy of HAI of irinotecan combined with 5-fluorouracil and leucovorin for liver metastases from CRC, specifically in patients also treated with LDP.
The role of floxuridine in metastatic liver disease
TLDR
Floxuridine is an ideal drug for hepatic arterial infusion (HAI) due to its short half life, steep dose response curve, high total body clearance, and high hepatic extraction, which limits systemic side effects.
Survival and quality of life in gastrointestinal tumors: two different end points?
TLDR
In many gastrointestinal cancers, chemotherapy can produce a survival gain and an improvement in the quality of life, and studies assessing new drugs and/or combinations should focus on these aspects and their relationships.
Colorectal liver metastasis thymidylate synthase staining correlates with response to hepatic arterial floxuridine.
TLDR
It is suggested that a prospective assessment of TS staining intensity in colorectal liver metastases would be useful to determine whether this method can be used to define patients who will benefit from HAI chemotherapy.
Continuous infusion of hepatic arterial irinotecan in pretreated patients with colorectal cancer metastatic to the liver.
TLDR
Five-day continuous hepatic arterial infusion of irinotecan 20 mg/m(2)/day has low activity in patients with liver metastases of colorectal cancer previously treated by chemotherapy.
Cost-effectiveness of palliative chemotherapy in advanced gastrointestinal cancer.
TLDR
The results of this study suggest that palliative chemotherapy is cost-effective in patients with advanced gastric and colorectal cancer.
Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer: a randomized trial of efficacy, quality of life, and molecular markers (CALGB 9481).
TLDR
HAI therapy increased overall survival, response rate, THP, and was associated with better physical functioning compared with systemic therapy, and additional studies need to address the overall benefit and cost of new chemotherapy agents versus HAI alone or the combination of HAI with new agents.
Current Role of Hepatic Artery Infusion and Isolated Liver Perfusion for the Treatment of Colorectal Cancer Liver Metastases
TLDR
There are many treatment options for patients with metastatic colorectal carcinoma confined to the liver, with responses being achieved in patients with advanced tumor burden and in those who have disease progression through prior treatment of hepatic metastases.
Hepatic Arterial Infusion Chemotherapy in Gastric Cancer: A Report of Four Cases and Analysis of the Literature
TLDR
The prognosis is significantly better in gastric cancer patients who have limited hepatic involvement and attain an objective response after HAI, and HAI seems to be similarly effective in these patients as in patients with liver metastases from colorectal cancer.
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TLDR
Based on data, it cannot recommend treatment with intra-arterial floxuridine as given in this study for metastatic colorectal cancer to the liver.
Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial.
TLDR
Therapy with HAI of FUDR improves the survival of patients with liver metastases over colorectal carcinoma, and efficient systemic chemotherapy, such as a combination of 5-FU and leucovorin, are required to prevent extrahepatic metastases.
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TLDR
A small gain in survival seen in a select subgroup of patients with negative hepatic nodes appeared to be offset by the toxicity of I.A.V. FUDR, which allowed more drug delivery to liver tumors, which resulted in increased tumor responses when compared with use of systemic therapy.
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Morbidity due to acalculous cholecystitis and gastroduodenal ulceration can now be avoided and continuous IA FUDR infusion should remain under the aegis of dedicated treatment centers until standardized protocols with diminished toxicity are established.
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The use of hepatic arterial dexamethasone is associated with an increased response rate and a trend toward increased survival and decreased bilirubin levels, and the authors recommend additional investigation of the use of dexamETHasone with chemotherapy to treat hepatic metastases.
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