Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1406
Peer-review started: December 12, 2016
First decision: December 19, 2016
Revised: December 29, 2016
Accepted: January 11, 2017
Article in press: January 11, 2017
Published online: February 28, 2017
To evaluate the efficiency and safety of hepatic artery infusion chemotherapy (HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer (CRC) liver metastasis (CRCLM).
A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed.
The median survival time (MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed (TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil (FOLFOX) arm (P = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm (P = 0.734). Median progression-free survival (PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm (P = 0.215). Leukopenia (P = 0.026) was more common in the FOLFOX arm, and hepatic disorder (P = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.
No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.
Core tip: Our study shows that hepatic artery infusion chemotherapy (HAIC) with either TOMOX (oxaliplatin plus raltitrexed) or FOLFOX (oxaliplatin plus 5-fluorouracil) was proven to be an efficient and safe alternative choice for patients with chemotherapy refractory colorectal cancer liver metastasis and no significant difference in survival was found between these two treatments. Cox univariate analysis shows that response to HAIC was a significant predictive factor.