thesis
Isolated Liver and Limb Perfusion in Preclinical and Clinical Studies: gene therapy and biochemotherapeutic strategies
- Publication date
- 15 May 2004
- Publisher
- __Abstract__
The liver is the major site of metastatic spread of primary colorectal cancer, whereas 3% of all
patients with colorectal cancer will develop resectable liver metastases. If a resection with
curative intent is done, a five year survival rate of 25-30% has been demonstrated in a large
number of studies. The natural history of untreated patients with comparable liver
involvement shows a five year survival rate of 0-3% (8). As noted above, the majority of
patients with evidence of liver metastases are irresectable, because of extra-hepatic disease or
excessive liver involvement.
There is no standard treatment for unresectable hepatic metastases confined to the liver, so novel
treatment modalities have to be developed. In order to achieve a better control of intrahepatic
disease and to reduce systemic toxicity of the applied therapy, locoregional therapies have
been developed. These therapies include hepatic arterial embolization (9), intratumoral
injections of ethanol, acetic acid, biological agents, stereotactic or intra-arterial
radiotherapy, intralesional laser therapy, cryotherapy, radiofrequency ablation and
regional infusion or perfusion of chemotherapeutic drugs.