Regional chemotherapy for advanced pancreatic carcinoma.
OBJECTIVE
Since 1990, 14 patients with advanced pancreatic cancer were treated by regional chemotherapy. Five patients had locally advanced unresectable cancer and 9 had locally advanced disease with liver metastasis.


METHODS
Fourteen patients underwent laparotomy, splenic artery catheterization and received a mean therapy of 3.8 cycles and 3 patients had completed 6 cycles of chemotherapy. Every cycle given monthly consisted of 5-fluorouracil 600 mg/m2 3 days, mitomycin 10 mg/m2 1 day, and cisplatinum 60 mg/m2 1 day. Tumor response was evaluated on the basis of imaging methods, tumor markers and life quality marker pain relief.


RESULTS
Four patients had stabilization, 4 had partial response, 5 had progression and 1 had complete response. Median survival was 8 months for the whole group. Palliation for pain was successful and 71.4% of the patients had pain palliation. One patient had complete, 1 patient had partial, 8 patients had stable pain relief. Four patients had poor response to treatment and had progressive pain. Side effects, mainly leukopenia and thrombocytopenia, occurred in 5 patients and responded to medical measures. Mild to moderate nausea and vomiting was common and they responded well to antiemetic treatment.


CONCLUSIONS
Although the objective response rate of regional chemotherapy for overall survival is low, in an individual patient it may produce an adequate response and acceptable toxicity so that the patient experiences overall improvement in symptoms, and rarely as in one case in our group may be cured by this method.
Department of Surgery, Section of Surgical Oncology, Ankara University School of Medicine, Ankara, Turkey. sancarb@hotmail.com
Sancar
S
Bayar
Ekrem
E
Unal
Mesut
M
Tez
Hilmi
H
Kocaoglu
Salim
S
Demirci
Hikmet
H
Akgul
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002445:Celiac Artery; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology
D016685:Mitomycin; D002945:Cisplatin; D005472:Fluorouracil