Response rate among the patients in this study.

We identified an effective chemotherapy regimen in patients refractory to standard chemotherapy. We included patients with unresectable colorectal liver metastases who underwent hepatic artery infusion chemotherapy and systemic chemotherapy between January 2015 and December 2022. This study was a retrospective analysis conducted at a single center. The patients received either biweekly oxaliplatin and 5-fluorouracil through hepatic artery infusion chemotherapy as well as bevacizumab and leucovorin injected intravenously (HAIC-FOLFOX-B) or biweekly irinotecan and 5-fluorouracil by hepatic artery infusion chemotherapy and bevacizumab and leucovorin injected intravenously (HAIC-FOLFIRI-B). Of the 42 patients, 20 underwent HAIC-FOLFOX-B while 22 underwent HAIC-FOLFIRI-B treatment with response rates of 25% and 4.5%, respectively. The median overall survival and progression-free survival were 12.9 and 4.7 months and 17.4 and 7.7 months in patients undergoing HAIC-FOLFOX-B and HAIC-FOLFIRI-B, respectively. The overall incidence of grade 3/4 toxicity was 23.8%. However, no treatment-related deaths occurred. Functional catheter-associated problems occurred in 9.5% of the patients. Hepatic arterial occlusion occurred in three patients (7.1%); catheter-associated infection occurred in one (2.4%) patient. However, these occurrences were not life-threatening complications. HAIC-FOLFOX-B and HAIC-FOLFIRI-B might improve survival in patients with unresectable colorectal liver metastases and in those who underwent both systemic oxaliplatin-based and irinotecan-based chemotherapies and were refractory to them. HAIC FOLFOX-B and FOLFIRI-B regimens might be effective therapeutic options in patients with unresectable colorectal liver metastases refractory to standard systemic chemotherapy.

本研究针对经标准化疗难治的患者，探索有效化疗方案。研究纳入2015年1月至2022年12月期间，接受肝动脉灌注化疗（hepatic artery infusion chemotherapy, HAIC）联合全身化疗的不可切除结直肠癌肝转移患者，为单中心回顾性分析。患者分别接受两种治疗方案：其一为每两周一次的肝动脉灌注奥沙利铂（oxaliplatin）联合5-氟尿嘧啶（5-fluorouracil），联合静脉输注贝伐珠单抗（bevacizumab）与亚叶酸钙（leucovorin），即HAIC-FOLFOX-B方案；其二为每两周一次的肝动脉灌注伊立替康（irinotecan）联合5-氟尿嘧啶，联合静脉输注贝伐珠单抗与亚叶酸钙，即HAIC-FOLFIRI-B方案。本队列共42例患者，其中20例接受HAIC-FOLFOX-B治疗，22例接受HAIC-FOLFIRI-B治疗，两组客观缓解率分别为25%与4.5%。HAIC-FOLFOX-B组与HAIC-FOLFIRI-B组的中位总生存期（median overall survival, OS）分别为12.9个月与17.4个月，中位无进展生存期（median progression-free survival, PFS）分别为4.7个月与7.7个月。3/4级不良事件总发生率为23.8%，未出现治疗相关死亡。导管相关功能异常发生率为9.5%：其中3例（7.1%）发生肝动脉闭塞，1例（2.4%）出现导管相关感染，上述并发症均未危及生命。研究结果显示，HAIC-FOLFOX-B与HAIC-FOLFIRI-B方案可改善经含奥沙利铂方案与含伊立替康方案的标准全身化疗后仍难治的不可切除结直肠癌肝转移患者的生存结局，两类方案或可作为此类经标准全身化疗难治的不可切除结直肠癌肝转移患者的有效治疗选择。