Therapy of Liver Tumors Metastatic from Colorectal Cancer with Whole-liver Radiation Combined with 5-FU, Adriamycin, and Methotrexate

Twenty-seven patients with liver metastasis from colorectal cancer were treated with intrahepatic arterial chemotherapy and external radiotherapy consisting of 5-fluorouracil (5-FU) (10 mg/kg/day for 8 days), adriamycin (5 mg/m2/day for 7 days) and methotrexate (MTX) (240 mg/m2/X1), combined with 2,100 rads of whole liver irradiation. Twenty of these patients (74%) had previously received systemic chemotherapy. Of the 21 patients who could be fully evaluated, seven (33%) had an objective partial response and another 10 (48%) had stable disease following treatment. The median duration of survival for all patients after initiation of treatment was 6.5 months. Those patients responding to therapy survived longer (12.7 months) than those who had stable disease (5.5 months) or disease progression (2.5 months). The response rate was not affected by previous chemotherapy. Additionally, of the 14 patients with symptoms related to the disease, nine (64%) experienced substantial relief of these symptoms. Toxicity with the therapy used in this study was generally moderate. The median nadiR WBC was 3,500 cells/mm3; the median nadir platelet count, 121,000 cells/mm3. There was, however, one treatment-associated fatality from sepsis in a patient whose WBC was 900 cells/mm3.