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Intra-arterial floxuridine vs systemic fluorouracil for hepatic metastases from colorectal cancer. A randomized trial.

Abstract
Seventy-four patients with liver metastasis from proved colorectal primary adenocarcinoma were entered into a prospective, randomized clinical trial to evaluate treatment with intra-arterial floxuridine compared with standard outpatient therapy with fluorouracil delivered by intravenous bolus injection. Eligible patients were randomized to hepatic arterial chemotherapy with an implanted infusion pump or systemic chemotherapy. No crossover between treatment arms was permitted, and patients were followed up to progression and death. Objective tumor response was observed in 48% of patients receiving intra-arterial floxuridine and in 21% of patients receiving intravenous fluorouracil. Time to hepatic progression was significantly longer in the group given intra-arterial therapy: 15.7 vs 6.0 months. However, time to overall progression (6.0 vs 5.0 months) and survival (12.6 vs 10.5 months) were not statistically different. Based on these data, we cannot recommend treatment with intra-arterial floxuridine as given in this study for metastatic colorectal cancer to the liver.
AuthorsJ K Martin Jr, M J O'Connell, H S Wieand, R J Fitzgibbons Jr, J A Mailliard, J Rubin, D M Nagorney, L K Tschetter, J E Krook
JournalArchives of surgery (Chicago, Ill. : 1960) (Arch Surg) Vol. 125 Issue 8 Pg. 1022-7 (Aug 1990) ISSN: 0004-0010 [Print] United States
PMID2143063 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Floxuridine
  • Fluorouracil
Topics
  • Adenocarcinoma (pathology)
  • Aged
  • Colorectal Neoplasms (pathology)
  • Female
  • Floxuridine (administration & dosage, adverse effects)
  • Fluorouracil (administration & dosage, adverse effects)
  • Humans
  • Infusion Pumps, Implantable (adverse effects)
  • Infusions, Intra-Arterial
  • Injections, Intravenous
  • Liver Neoplasms (drug therapy, mortality, secondary)
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Survival Rate

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