Transarterial Chemoembolization with Irinotecan-loaded Beads Followed by Arterial Infusion of 5-Fluorouracil for Metastatic Liver Tumors Refractory to Standard Systemic Chemotherapy.

We report two cases of liver metastases from colorectal and anal cancers after the failure of systemic chemotherapies that were successfully treated with a combination therapy of transarterial chemoembolization using irinotecan-loaded drug-eluting beads and hepatic arterial infusion chemotherapy. In both cases, hepatic arterial infusion chemotherapy was performed as maintenance therapy after irinotecan-loaded drug-eluting beads. Irinotecan at a dose of 120 mg was loaded on drug delivery beads for irinotecan-loaded drug-eluting bead-transarterial chemoembolization. A weekly high-dose 5-fluorouracil regimen (1000 mg/m²/5 h) was used for hepatic arterial infusion chemotherapy. The liver metastases shrank remarkably in both cases, and progression-free survivals of 13 and 9 months, respectively, were obtained without any severe adverse events.