title: Intermittent regional infusion of chemotherapy for pancreatic adenocarcinoma. Phase I and II pilot study.
abstract: Nineteen patients with unresectable and metastatic adenocarcinoma of the pancreas and ampulla of Vater were treated with intermittent regional infusion of the celiac axis (CAI) with the combination of 5-fluorouracil, adriamycin, mitomycin-C, and streptozotocin (FAM-S). Three schedules with escalating doses were investigated. The arterial infusion was repeated at 4 weeks, and in responding and stable patients, I.V. FAM-S was continued at monthly intervals. Twelve patients had measurable disease, and in this group one complete response and seven partial responses occurred. Median duration of response was 6+ months and median survival for all patients was 5.2 months. Four patients had catheter-related complications (emboli, three, sepsis, one). Hematologic and gastrointestinal toxicity was minimal. Celiac artery infusion with FAM-S in locally extensive and metastatic adenocarcinoma of the pancreas and ampulla of Vater is a relatively simple procedure associated with low incidence of serious complications and toxicity but a higher response rate than previously reported. Induction of response with CAI and subsequent maintenance therapy with intravenous chemotherapy is under investigation.
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D014670:Ampulla of Vater; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols; D002445:Celiac Artery; D003138:Common Bile Duct Neoplasms / Q000188:drug therapy; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D013311:Streptozocin / Q000008:administration & dosage
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D008937:Mitomycins; D016685:Mitomycin; D013311:Streptozocin; D004317:Doxorubicin; D005472:Fluorouracil