Regional chemotherapy for colorectal cancer metastatic to the liver.

Regionally directed therapies, especially hepatic intra-arterial chemotherapy, have produced encouraging results against liver metastases from colorectal cancer. An implanted system allows treatment to be administered in the outpatient setting. Intra-arterial floxuridine has been shown to produce an increased response rate and prolonged time to progression of intrahepatic tumor compared to conventional treatment, but whether or not survival is prolonged has not yet been determined. Hepatobiliary toxicity from floxuridine limits the duration of therapy. Other experimental methods of regional therapy include chemoembolization, chemofiltration and mechanical alterations in hepatic arterial flow rate.