Regional chemoimmunotherapy for nonresectable metastatic liver disease of colorectal origin. A prospective randomized study.

BACKGROUND/AIMS: The study has been designed to assess the potential advantages of regional targeting chemoimmunotherapy versus systemic chemotherapy and immunotherapy in a number of patients suffering from nonresectable metastatic liver disease of colorectal origin. METHODOLOGY: From January 1996 to January 2001 (86) patients with unresectable metastatic liver disease of colorectal origin were randomly assigned to two groups. Group A (n = 44 patients), who received regional targeting chemoimmunotherapy through an arterial catheter introduced subcutaneously under echo guidance into the hepatic artery. Group B (n = 42 patients) received systemic chemoimmunotherapy. RESULTS: Survival of Group A patients ranged from 9 to 48 months (mean: 33 months), while Group B patients' survival ranged from 8 to 18 months (mean: 10 months). Response to treatment was 75% for Group A patients versus 52% for Group B. There were statistically significant differences in survival between the two groups (P = 0.0001). CONCLUSIONS: We believe that the data of this study reconfirms previously reported experience about the advantages of regional chemoimmunotherapy when compared with systemic chemoimmunotherapy for the management of advanced metastatic liver disease.