[Intra-arterial chemotherapy for hepatic metastases. Experience of the Pitié-Salpêtrière Hospital Group].

: Intra-arterial chemotherapy of hepatic metastases is theoretically interesting because of the essentially arterial blood supply of these metastases in contrast with the healthy tissue and because of the theoretical pharmacokinetic advantage for certain drugs, depending on their quotient of hepatic extraction and the wole body clearance. We have treated 43 patients with this technique. The primary cancer was a cancer of the colon in 10 patients, a breast cancer in 16 patients, a melanoma in 7 patients and cancers of other sites in 10 patients. The chemotherapy was initially administered by selective catheterisation of the hepatic artery via an axillary approach and usually consisted of a bolus injection of adriamycin 40 mg/m2 and mitomycin 10 mg/m2 and an infusion of 5 FU 1 g/m2 for 24 to 72 hours. In 15 patients, we surgically implanted a subcutaneous reservoir and catheter. To date, we have performed 114 arterial injections via the catheter and 60 injections into sub-cutaneous reservoirs. We have observed few complications, apart from thrombosis of the axillary artery (3 cases) and of the hepatic artery (5 cases). We have obtained 4 complete responses, 16 partial responses, 8 stabilisations, 10 failures and, unfortunately, 5 patients died rapidly after a single course of chemotherapy and could not be evaluated. The response rate was particularly high for the breast cancers (about 60 percent) and the cancers of the colon (more than 50 percent). We have also observed 3 complete responses in patients treated by intravenous chemotherapy with the same protocol.