A case of locally extended rectal cancer responding to intra-arterial infusion therapy via the internal iliac artery

Chemotherapy with combined administration of 5-FU and l-Leucovorin has been reported to be effective for advanced rectal cancer. A 61-year-old woman with a huge, locally extended advanced rectal cancer was treated with intra-arterial infusion therapy via internal iliac artery. Catheters were inserted from the bilateral femoral arteries to the opposite internal iliac arteries and the bilateral upper and lower gluteal arteries and lateral sacral artery were embolized with a metallic coil. The port was positioned under the skin of her lower abdominal wall. The chemotherapy regimen was 5-FU (500 mg/body) and l-Leucovorin (250 mg/m2), administered over 5 hours once weekly to bilateral reservoirs through an infuser pump. After 5 sessions of the chemotherapy, the perineal pain decreased and the patient no longer needed morphine. Following 34 administrations (at 10 months) of this regimen, reductions of tumor size on pelvic CT and CEA level were confirmed. Side effects of the intra-arterial infusion chemotherapy were pygal dermatitis, leg desensitization, infection of circumferential reservoir and obstruction of the catheter due to flection were observed. Local intra-arterial infusion chemotherapy via the internal iliac artery appears to be effective for local advanced rectal cancer.