Safety and Efficacy of trans-arterial Infusion Chemotherapy Combined with Lipiodol Chemoembolization for Advanced Colorectal Cancer: A Prospective Single-Center Clinical Study of 239 Patients in China

Abstract Background: Advanced colorectal cancer (CRC) patients who are ineligible for surgery or have failed standard treatments face limited therapeutic options. Trans-arterial infusion chemotherapy (TAI) combined with lipiodol chemoembolization may offer a targeted, effective intervention to improve outcomes in this population. Methods: In this prospective single-center study, 239 patients with advanced CRC received one to three sessions of intra-arterial infusion of oxaliplatin and raltitrexed, followed by embolization using a lipiodol-doxorubicin emulsion targeting tumor-feeding arteries. Treatment response was assessed using RECIST criteria. Safety, survival outcomes, and symptom relief were evaluated during follow-up. Descriptive and survival statistics were calculated using standard methods. Results: The disease control rate was 94.6%, with an objective response rate of 59.4%. Median overall survival was 21.7 months, and the mean follow-up duration was 20.1 months. Common adverse events included nausea (65.1%), abdominal discomfort (38.2%), tenesmus (39.8%), and myelosuppression (46.8%). All side effects were manageable with supportive care, and no serious perioperative complications such as intestinal necrosis or perforation occurred. Symptomatic relief was particularly notable in patients with tumor-related bleeding or obstruction. Most patients maintained a good performance status (ECOG 0–1) throughout follow-up. Conclusions: Super selective TAI combined with lipiodol chemoembolization appears to be a safe and effective locoregional treatment strategy for patients with advanced CRC. It offers promising disease control, symptomatic relief, and survival benefit, with tolerable toxicity. These findings support further prospective, multicenter randomized trials to validate clinical utility and refine patient selection criteria.