Oxaliplatin-Based Intra-arterial Chemotherapy in Colo-Rectal Cancer Liver Metastases: A Review from Pharmacology to Clinical Application

Abstract

Liver metastases (LM) are often consequences of colo-rectal cancer (CRC)and the majority of patients have unresectable LM. Oxaliplatin-based intravenous chemotherapy represents the gold standard treatment for CRC. Intravenous oxaliplatin has several side effects i.e., nephrologic, hematologic and neurological toxicity. Moreover, hepatic arterial infusion (HAI) of antitumor drugs deeply modifies the treatment of LMCRC due to the knowledge that LM are perfused by the hepatic artery network, whereas healthy tissue is perfused by the portal vein. Therefore, oxaliplatin-based HAI becomes an interesting possibility to treat LMCRC. The aim of this review is to shed light on the important impact of the oxaliplatin-based chemotherapy from a non-conventional clinical point of view, considering that, being universally accepted its antitumor effect if administered intravenously, fragmentary information are known about its clinical applications and benefits deriving from intra-arterial administration in loco-regional chemotherapy.

Keywords: arterial catheter; intra-arterial chemotherapy; liver metastases; platinum complexes.

Figure 1

Chemical structure of (a) Cisplatin, (b) Carboplatin and (c) Oxaliplatin.

Figure 2

The arterial phase of the contrast angiogram shows the subcutaneous port and the hepatic-artery catheter (A.) The arterial phase of the contrast angiogram shows the hepatic-artery (thin arrow), the preparation of the vascular bed (double thin arrow) and the hepatic-artery catheter (large arrow). (B.) The arterial phase of the contrast angiogram shows the subcutaneous port (thin arrow) with its connection system and the hepatic-artery catheter (large arrow).