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Bowel cancer commonly spreads to the liver. In most patients this cannot be removed by an operation and cure is not possible. Chemotherapy treatment can help control the growth of the cancer and improve survival. Radioactive beads can be injected into the blood vessels of the liver to try and control the cancer in the liver. In one study that had 21 participants, radioactive beads (injected into the blood vessels of the liver) given with chemotherapy (into the veins of the arm) was more effective at controlling the cancer and improving how long people lived than chemotherapy given on it's own. However, in this study more people who received the radioactive beads suffered from side effects and this study used an older type of chemotherapy that is less effective than the newer treatments that are now available. In a second study with 63 participants, radioactive beads were given with chemotherapy that was injected directly into the blood vessels of the liver. In this study there was no extra benefit in the control of cancer growth or survival for those participants who received radioactive beads in addition to the chemotherapy. More studies are needed with a particular focus on whether radioactive beads provides extra benefit when given with newer chemotherapy treatments, and if radioactive beads provide benefit when given on their own.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

The standard treatment for unresectable liver‐confined metastatic disease from colorectal cancer (CRC) is systemic chemotherapy (SCT). Unfortunately, the prognosis of these patients is dismal and SCT is virtually never curative. Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the diseased organ (i.e., the liver), the benefit in terms of overall survival (OS) is unclear and the use of HAI is debated. This meta‐analysis quantitatively summarizes the results of the ten randomised controlled trials (RCT) comparing HAI with systemic chemotherapy (SCT). Our findings show that administration of fluoropyrimidines through HAI yields higher tumor response rates as compared to the SCT regimens used in the analysed RCT. However, this anticancer activity does not translate into a significant survival advantage for patients treated with HAI as compared to those given SCT. Also considering that modern SCT can achieve higher response rates as compared to the regimens adopted in the analysed RCT, the currently available evidence does not support the clinical or investigational use of fluoropyrimidine‐HAI alone for the treatment of patients with unresectable CRC liver metastases.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Intravenous (IV) fluoropyrimidines are an essential part of chemotherapy treatment for colorectal cancer (CRC). Patients prefer tablets as long as they work as well and are as safe as IV treatment, because they are easier to take and are more convenient.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

The study found that trials comparing different settings for delivering intravenous chemotherapy appear difficult to conduct. Consequently, few conclusions can be reached regarding the clinical effectiveness and cost-effectiveness of the home, community and outpatient settings. Future studies could produce more informative data if careful consideration is given to study design.

Health Services and Delivery Research - NIHR Journals Library.

Version: April 2015

This review concerns anti‐cancer drug treatment for women with GTN that does not respond to first‐line treatment or that re‐occurs. GTN is the name given to a type of cancer that arises from placental tissue following pregnancy, most frequently a molar pregnancy. Molar pregnancies are benign abnormal growths of placental tissue inside the womb. Most are cured by evacuation (D&C) of the womb, however, in up to 20% of cases they become malignant. GTN is usually very responsive to anti‐cancer drugs (chemotherapy), however, these drugs can be toxic, therefore the aim of treatment is to achieve a cure with the least side effects. To help doctors select the most appropriate treatment for women with GTN, the disease is classified as low‐ or high‐risk according to specific risk factors.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Expert-reviewed information summary about the treatment of colon cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 18, 2017

Expert-reviewed information summary about the treatment of vaginal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: February 9, 2017

Expert-reviewed information summary about the treatment of gestational trophoblastic disease.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: February 25, 2015

Using a linked evidence approach, the study found that My5-FU appears to be cost-effective at a willingness to pay of £20,000 per quality-adjusted life-year for both metastatic colorectal cancer and head and neck cancer, but there is considerable uncertainty around these estimates.

Health Technology Assessment - NIHR Journals Library.

Version: November 2015

Study found that there is limited evidence on the clinical effectiveness and cost-effectiveness of ablative and other minimally invasive therapies for treating people with liver metastases. Results are presented for a number of ablative and minimally invasive therapies, but all studies had methodological shortcomings, few had a comparator group and there were with limited analyses and many uncertainties. There is scope for further research.

Health Technology Assessment - NIHR Journals Library.

Version: January 2014

Expert-reviewed information summary about the treatment of rectal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 27, 2017

PURPOSE: The treatment of unresectable liver-confined metastatic disease from colorectal cancer (CRC) is a challenging issue. Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the affected organ, the benefit in terms of overall survival (OS) is unclear. We quantitatively summarized the results of randomized controlled trials (RCT) comparing HAI with systemic chemotherapy (SCT).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

This review assessed the effect on survival of adjuvant hepatic arterial infusion chemotherapy after curative hepatic resection for colorectal cancer liver metastases. The authors found a small but non-statistically significant improvement in 1- and 2-year survival. The authors' conclusions appear reliable, although they did not address the impact of variation in treatment regimens and duration.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

This review assessed the effect of radioembolism with yttrium-90 microspheres on overall response and survival in patients with colorectal liver metastases or hepatocellular carcinoma and concluded that yttrium-90 resin microspheres delivered high response rates. As many aspects of the review process (including the analysis) were not reported clearly, the reliability of the authors’ conclusion is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

The authors concluded that systemic perioperative chemotherapy provided benefit in the treatment of patients with resected stage IV colorectal cancer, but that the results should be interpreted cautiously; further research is needed. Given the uncertainties surrounding the pooling of the trials and statistical methods used, the authors' advice to interpret their findings with caution should be heeded.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

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