Hepatic arterial infusion of 5-fluorouracil and extrabeam radiotherapy for liver metastases from pancreatic carcinoma.
OBJECTIVE
To examine the efficacy and safety of a combined modality therapy consisting of hepatic arterial infusion of 5-fluorouracil and external-beam radiotherapy in patients with advanced pancreatic carcinoma.


METHODS
Hepatic arterial infusion chemotherapy consisted of 5-FU 1000mg/m2 administrated as a 5-hr continuous infusion once weekly. External-beam radiotherapy (total dose, 50Gy; 2Gy/day) was delivered to the pancreas tumor concurrently for 5-6 weeks. Seventeen patients with no distant metastases except to the liver were enrolled in this study.


RESULTS
Patients received a median of 13 cycles of chemotherapy. Sixteen of 17 patients received a total radiotherapy dose of 50Gy. In one patient, treatment was discontinued after 24Gy of radiotherapy and 2 cycles of chemotherapy because of progressive disease. Nausea and vomiting were the most common types of toxicity. Grade 3 or worse toxicity was observed in 2 patients. Four patients developed gastroduodenal ulcers. Of the 16 patients, 7 (41%) showed a partial response, and 9 (53%) showed no change. The median overall survival was 4.5 months and 1-yr overall survival of 11.8% was observed.


CONCLUSIONS
The combined therapy is active and well tolerated, but results in a poorer prognosis, in spite of its high initial response rate.
Ishii
Hiroshi
H
Division of Hepatobiliary Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan. hirishii@east.ncc.go.jp
Furuse
Junji
J
Nagase
Michitaka
M
Yoshino
Masahiro
M
Kawashima
Mitsuhiko
M
Satake
Mitsuo
M
Ogino
Takashi
T
Ikeda
Hiroshi
H
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011832:Radiation Injuries; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil