Folfox4 Regimen Administered Through Combined Hepatic Arterial And Systemic Infusion For Treatment Of Colorectal Cancer With Unresectable Liver Metastases

e14138 Background: Liver metastasis is the most common type of metastasis of colorectal cancer (CRC), and was found in 60-70% at autopsy. Only about 10% patients are amenable to hepatectomy, which is currently the only curative treatment. Hepatic arterial chemotherapy is an attractive alternative treatment to systemic chemotherapy, since 90% of blood supply to liver metastases is through hepatic artery, and that a higher drug concentration can be delivered to the metastatic tumor. Methods: Inclusion criteria: CRC patients with unresectable hepatic metastases and no prior chemotherapy during 2006-2009 in Peking Union Medical College Hospital were included. Treatment regimen: first day: HAI of oxaliplatin over 2h and L-folinic acid over 2h, followed by a bolus HAI of 5-fluorouracil (5-FU) then continuous HAI of 5-FU over 20 h; second day: Intravenous infusion of L-folinic acid over 2h followed by 5-FU bolus then continuous infusion of 5-FU over 22 h. The patients received HAI and systemic venous administration during the odd cycles, and the intravenous administration of the same regimen during the even cycles. Results: 27 colorectal cancer patients with unresectable hepatic metastases and no prior chemotherapy were enrolled in the study. A total of 236 treatment cycles were given with a median of 10 cycles. The therapy generated the following results after 6 cycles: CR 1/27 (3.7%), PR 16/27 (63.0%), SD 6/27 (22.2%) and PD 3/27 (11.1%). Four patients had hepatectomy. A median time to progression of 11 months and a median overall survival period of 24 months were documented. The major adverse events include grade±-II nausea/vomiting, upper abdominal pain, peripheral neuropathy, neutropenia/ thrombocytopenia. Conclusions: The FOLFOX4-like chemotherapy regimen was efficacious and safe for the treatment of metastatic CRC lesions in the liver, and facilitated the control of local lesions.