Intrahepatic Chemotherapy 2 for Metastatic Colorectal Cancer

Colorectal cancer (CRC) is the fourth most common malignancy in the United States (1). Approximately 130,000 new patients will be diagnosed with this cancer in 1999. It is the second leading cause of cancer death, with 55,000 patients expected to die of it. Most patients die of metastatic disease. The vast majority of them have liver as the dominant site of metastases (2). Approximately 30% of patients with metastatic CRC have disease confined to the liver; 10–25% of patients undergoing resection of primary CRC have synchronous hepatic metastases. Potentially curative resection is possible in a minority of patients with hepatic disease. Systemic chemotherapy produces response rates of 15–30%, with median survival of 10–12 mo. It is estimated that 30,000 patients are candidates for regional hepatic therapy each year. Thus, the impact of this malady is substantial. The anatomic and pharmacokinetic advantage of intraarterial chemotherapy in patients with hepatic disease makes it an attractive therapeutic option. Regional hepatic arterial infusion (HAI) chemotherapy can be administered via a hepatic arterial port