Article

Chemotherapy for malignancy of the liver by short-term direct infusion of the hepatic artery

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Abstract

SYSTEMIC chemotherapy with primarily 5-fluorouracil (5Fu) has achieved significant palliation in only about 20 percent of cases of advanced gastrointestinal malignancy.1, 2 The low percentage of successful results has led to a search for other means of effective therapy. Catheterization of the hepatic artery with direct infusion of 5Fu and other drugs has been utilized for hepatic malignancies. This technic has been used on a long-term program by means of a permanently indwelling catheter,3–5 and also for short-term courses of therapy.6–8 Beneficial results of chemotherapy by infusion of the hepatic artery have been reported by Sullivan and associates,3, 4 by Nora, Kukral, and Preston,7 by Ariel and Pack,8 by Brennan and associates,5 and by Fletcher, Chandler, and Donaldson.9

Because of the favorable reports, in August 1964 we began a study of the chemotherapy of hepatic malignancy by direct arterial infusion of 5Fu on a short-term basis. This is a report of the first 16 patients treated by this method.

Procedure

All patients with primary or metastatic malignant neoplasms confined to the liver were considered to be eligible for the study. Histologic verification of the hepatic malignancy was obtained in all cases. This was done by means of laparotomy in 10 patients, and by percutaneous liver biopsy in six patients. No patient had evidence of spread of the malignant lesion beyond the liver at the time the treatment was instituted. All patients had undergone previous operation for the primary malignant lesion.

The series comprised 11 men and 5 women,. . .


 

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