%0 Journal Article
%T Modern Prospection for Hepatic Arterial Infusion Chemotherapy in Malignancies with Liver Metastases
%A Yi-Hsin Liang
%A Yu-Yun Shao
%A Jia-Yi Chen
%A Po-Chin Liang
%A Ann-Lii Cheng
%A Zhong-Zhe Lin
%J International Journal of Hepatology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/141590
%X Malignancy with liver metastasis plays an important role in daily oncology practice, especially for primary cancers of the gastrointestinal tract and hepatopancreatobiliary system. On account of the dual vascular supply system and the fact that most metastatic liver tumors are supplied by the hepatic artery, hepatic artery infusion chemotherapy (HAIC) is an appealing method for the treatment of liver metastases. Herein, we summarize recent study results reported in the literature regarding the use of HAIC for metastatic liver tumors, with special focus on colorectal cancer. 1. Introduction Malignancy with liver metastasis plays an important role in daily oncology practice, especially for primary cancers of the gastrointestinal (GI) tract and hepatopancreatobiliary system [1]. The liver is commonly the first site of distant metastasis. For example, about three-quarters of patients with stage IV colorectal cancer (CRC) have liver metastases [2]. Many of these patients have metastatic disease confined to the liver only. It has been demonstrated that for patients with such limited distant metastases, locoregional therapy such as surgery may be helpful [3, 4]. However, usually the liver metastases are too advanced to be resected by hepatectomy. Fewer than 15% of these patients receive hepatectomy to a curative extent [5]. On account of the dual vascular supply system and the fact that most metastatic liver tumors are supplied by the hepatic artery [6, 7], hepatic artery infusion chemotherapy (HAIC) is an appealing method for the treatment of liver metastases. HAIC has several advantages over intravenous chemotherapy. First, chemotherapeutic agents can be delivered more specifically to malignant cells. Normal hepatocytes that mostly rely on the portal venous system are thus exposed to fewer chemotherapeutic agents. Second, many chemotherapy agents used in HAIC have a high first-pass hepatic clearance effect, such as 5-fluorouracil (5-FU) and floxuridine (FUDR), a prodrug of 5-FU. Over 90% of FUDR and 19%¨C50% of 5-FU are cleared by the liver when they are administered by HAIC [8]. Systemic exposure to chemotherapeutic agents is thus decreased. These two mechanisms enable HAIC to provide a higher exposure of chemotherapy to malignant cells with minimized toxicities. The higher drug level may also overcome drug resistance. For example, intravenous (IV) anthracyclines are generally considered ineffective for CRC. HAIC with pirarubicin, an anthracycline that is an analogue of doxorubicin, has been demonstrated to have a fair efficacy in CRC patients with liver
%U http://www.hindawi.com/journals/ijh/2013/141590/