Intra-arterial Floxuridine vs Systemic Fluorouracil for Hepatic Metastases From Colorectal Cancer

A Randomized Trial

J. Kirk Martin, Michael J. O'connell, Harry S. Wieand, Robert Joseph Fitzgibbons, James A. Mailliard, Joseph Rubin, David M. Nagorney, Loren K. Tschetter, James E. Krook

Research output: Contribution to journalArticle

350 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1022-1027
Number of pages6
JournalArchives of Surgery
Volume125
Issue number8
DOIs
StatePublished - 1990

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Floxuridine
Fluorouracil
Colorectal Neoplasms
Neoplasm Metastasis
Liver
Therapeutics
Drug Therapy
Infusion Pumps
Liver Neoplasms
Intravenous Injections
Adenocarcinoma
Outpatients
Randomized Controlled Trials
Survival
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Intra-arterial Floxuridine vs Systemic Fluorouracil for Hepatic Metastases From Colorectal Cancer : A Randomized Trial. / Martin, J. Kirk; O'connell, Michael J.; Wieand, Harry S.; Fitzgibbons, Robert Joseph; Mailliard, James A.; Rubin, Joseph; Nagorney, David M.; Tschetter, Loren K.; Krook, James E.

In: Archives of Surgery, Vol. 125, No. 8, 1990, p. 1022-1027.

Research output: Contribution to journalArticle

Martin, JK, O'connell, MJ, Wieand, HS, Fitzgibbons, RJ, Mailliard, JA, Rubin, J, Nagorney, DM, Tschetter, LK & Krook, JE 1990, 'Intra-arterial Floxuridine vs Systemic Fluorouracil for Hepatic Metastases From Colorectal Cancer: A Randomized Trial', Archives of Surgery, vol. 125, no. 8, pp. 1022-1027. https://doi.org/10.1001/archsurg.1990.01410200086013
Martin, J. Kirk ; O'connell, Michael J. ; Wieand, Harry S. ; Fitzgibbons, Robert Joseph ; Mailliard, James A. ; Rubin, Joseph ; Nagorney, David M. ; Tschetter, Loren K. ; Krook, James E. / Intra-arterial Floxuridine vs Systemic Fluorouracil for Hepatic Metastases From Colorectal Cancer : A Randomized Trial. In: Archives of Surgery. 1990 ; Vol. 125, No. 8. pp. 1022-1027.
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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.",
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