There are a variety of treatment options for patients with metastatic colorectal cancer confined to the liver. Although surgical resection is the only curative modality, a majority will not be able to undergo surgery. Alternative methods for treating this population have focused on the feasibility of hepatic arterial infusion of chemotherapy. Randomized trials evaluating the treatment of unresectable disease with hepatic artery infusion therapy have demonstrated higher response rates than those seen with systemic chemotherapy but variable results of survival benefit. With newly developed chemotherapeutic agents and technical advancement, several randomized trials of hepatic arterial infusion chemotherapy for hepatic metastasis of colorectal cancer are in the middle of ongoing. In this review, we will discuss about hepatic artery infusion chemotherapy regarding selection of patient, ideal chemotherapeutic agents, technique for catheter insertion and clinical outcomes of randomized trials.
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