Clinical Efficacy of Transarterial Infusion Chemotherapy for Unresectable Colorectal Cancer

Study population:

Patients who meet all inclusion criteria and none of the exclusion criteria are eligible for enrolment and study treatment.

Inclusion criteria:

1. Age ≥ 18 years old;
2. Histopathologically confirmed CRC adenocarcinoma;
3. Locally advanced CRC confirmed as clinical T4 stage on CT/MRI imaging, with or without synchronous liver metastases;
4. For patients with CRLM, hepatic tumor burden shall be lower than the burden of the primary colorectal lesion. Consequently, the multidisciplinary team (MDT) agree by consensus that CRC should be a priority target for treatment.
5. No prior administration of chemotherapy, targeted therapy or radiotherapy for the current malignancy;
6. Adequate haematological, heart, liver and renal functions are required, with the following specific criteria: white blood cell count≥4×109 /L, neutrophils≥1.5×109 /L, platelets≥100×10⁹ /L, haemoglobin≥100 g/L, total bilirubin≤34.2 μmol/L, aspartate aminotransferase≤100 IU/L, alanine aminotransferase≤100 IU/L, serum creatinine ≤133 μmol/L or creatinine clearance rate≥60 mL/min, and urine protein/creatinine\<1;
7. Estimated survival is more than 3 months;
8. Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2;
9. All the patients in this study are required to sign an informed consent form.

Exclusion criteria:

1. Patients have other primary malignant tumors;
2. Patients with recurrent CRC;
3. Patients with distant metastases besides synchronous hepatic metastases (e.g., pulmonary, bone, or brain metastases);
4. For patients with CRLM, the MDT consensus recommends a liver-first treatment strategy to avoid the risk of rapid hepatic lesion progression;
5. CRC patients with gastrointestinal perforation
6. Patients with malignant bowel obstruction refractory to conservative management;
7. Patients are allergic to the antitumor agents;
8. Women pregnant, breastfeeding or planning to become pregnant;
9. Patients receiving other antitumor therapies, such as chemotherapy, targeted therapy or radiotherapy;
10. Patients with MSI-H/dMMR CRC.