Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1406-1411
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1406
Hepatic artery infusion with raltitrexed or 5-fluorouracil for colorectal cancer liver metastasis
Jian-Hai Guo, Hang-Yu Zhang, Song Gao, Peng-Jun Zhang, Xiao-Ting Li, Hui Chen, Xiao-Dong Wang, Xu Zhu
Jian-Hai Guo, Hang-Yu Zhang, Song Gao, Peng-Jun Zhang, Hui Chen, Xiao-Dong Wang, Xu Zhu, MD, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional therapy, Peking University Cancer Hospital and Institute, Beijing 100142, China
Xiao-Ting Li, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Guo JH and Zhu X designed the research; Zhang HY, Gao S, Zhang PJ and Chen H analyzed the data; Zhang HY wrote the paper; Wang XD and Zhu X critically revised the manuscript for important intellectual content; Guo JH and Zhang HY contributed equally to this work and should be considered co-first authors; all authors contributed to this manuscript.
Supported by Capital Medical Development and Scientific Research Fund, China, No. 2014-2-2154.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Beijing Cancer Hospital.
Informed consent statement: Informed consent was waived.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xu Zhu, MD, Chief, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional therapy, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. drzhuxu@163.com
Telephone: +86-10-88196330
Received: December 10, 2016
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
Abstract
AIM

To evaluate the efficiency and safety of hepatic artery infusion chemotherapy (HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer (CRC) liver metastasis (CRCLM).

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Liver metastasis, Hepatic artery infusion chemotherapy, Raltitrexed, Colorectal cancer, FOLFOX

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.