We report a patient with metastatic colon
carcinoma who was treated effectively with a continuous intrahepatic artery-infusion of
5-FU,
Leucovorin and
cisplatin, and systemic
chemotherapy with
CPT-11. A 50-year-old man was diagnosed as having well differentiated
adenocarcinoma of the sigmoid colon with multiple liver
metastases in March, 1997. Left
hemicolectomy and subsequent catheterization into the common hepatic artery via the gastroduodenal artery were performed in April, 1997. He was treated with 3 courses of continuous intrahepatic artery-infusion of
5-FU,
Leucovorin and
cisplatin, and two courses of systemic
chemotherapy with
CPT-11 during hospitalization, followed by 6 courses of a similar intraarterial
therapy in an outpatient setting. Reinstallation of the
catheter into the hepatic artery via the femoral artery was performed because of occlusion of the reservoir. During the 6th course of intraarterial
therapy,
diarrhea,
nausea, and
vomiting appeared and angiography revealed a narrowing of the hepatic artery. Therefore, the intrahepatic artery-infusion
therapy was reinitiated with doses of
5-FU,
Leucovorin and
cisplatin reduced to approximately 80%. After 5 courses of this
therapy, the computed tomography scan showed a marked decrease in the size of the metastatic hepatic lesions by 90%, and the serum level of CEA decreased from 657.7 ng/ml to 4.5 ng/ml. No severe side effects were seen during the treatment. Though multiple lung
metastases were indicated during the intrahepatic artery-infusion
therapy, both the liver and lung
metastases have been well controlled with continuous intrahepatic artery-infusion
chemotherapy and systemic
chemotherapy. The continuous intrahepatic arterial infusion of
5-FU,
leucovorin and
cisplatin appears to be very effective for the treatment of colon
carcinoma with liver
metastasis without reducing the quality of life.