[A case of bilateral multiple liver metastases with distant lymph node metastases due to rectal cancer successfully treated with hepatic arterial infusion (HAI) of levofolinate (l-LV)/5-fluorouracil (5-FU) and radiotherapy].

The patient was a 43-year-old male with bilateral multiple liver metastases, who had undergone high anterior resection for rectal cancer (ss, n 0, P 0, H 3, M (-), stage IV). Hepatic arterial infusion (HAI) of low-dose CDDP (10 mg/body) and 5-FU (250 mg/body), 5 times a week, was ineffective for the liver metastases. Consequently, HAI of levofolinate (425 mg/body) and 5-FU (1,000 mg/body), once a week, was attempted. All metastatic liver tumors diminished apparently with calcification after the treatment (PR). Tumor marker (CA19-9 and CEA) levels decreased to less than one-tenth of the pretreatment levels and stabilized for approximately seven months. Mediastinal lymph node metastases, paraaortic lymph node metastases and tumor thrombus in the inferior vena cava were successfully treated with systemic chemotherapy using levofolinate and 5-FU and/or radiotherapy. Although the liver and lung metastases showed rapid growth, the patient died 2 years after the diagnosis of liver metastases. The liver metastases were well controlled for about 20 months. It is important to select interdisciplinary therapies according to the site of the metastases due to rectal cancer.