A prospective study of continuous hepatic perfusion with implantable pump

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Abstract
The delivery of chemotherapy through the implantable hepatic infusion pump in the management of patients with hepatic metastases secondary to carcinoma of the colon and rectum is evaluated in this preliminary prospective study. Patients were selected according to hepatic lobar distribution and magnitude, age and general systemic evaluation. Infusion pumps were implanted in a total of 14 patients who were judged to be unsuitable for hepatic resection. After pump implantation all patients were alive and well and receiving regional perfusion chemotherapy. For the 9 patients in this study who were monitored for a full 6 months, the median decrease in CEA [cinoembryonic antigen] levels was 49%. On computerized axial tomography (CT) and/or liver-spleen scan, 5 patients showed > 50% reduction in tumor size. All patients have demonstrated minimal systemic toxicity and have maintained a good quality of life. The results encourage further evaluation of perfusion chemotherapy.