Chemotherapy for Colorectal Cancer

Open Access
Publisher Website
Google Scholar
Abstract
We believe that hepatic atrial infusion, new drugs, and biochemical modulation deserve more attention than they received in Dr. Moertel's review of chemotherapy for colorectal cancer (April 21 issue)1. With respect to hepatic arterial infusion, two large studies with a crossover design demonstrated survival advantages for patients who were crossed over from systemic to hepatic arterial chemotherapy; two studies in which there was no survival advantage associated with hepatic therapy involved only small numbers of patients2. In the study by the National Cancer Institute,2 the median survival was 22 and 12 months for the groups receiving hepatic arterial infusion and systemic therapy, respectively, but the small number of patients (64) may have precluded a statistically significant difference in survival. In the Mayo Clinic study,2 49 percent of the 36 patients receiving hepatic arterial infusion were not adequately treated, which potentially affected the results. In recent studies of hepatic arterial infusion, the median survival is over 27 months and the 2-year survival is 64 percent3.