title: [Two cases of advanced gallbadder cancer with para-aortic lymph node metastasis responding to intra-aortic infusion of gemcitabine and low-dose CDDP/5-FU].
abstract: Patients with gallbadder cancer associated with remarkable lymph node involvement along the para-aortic region are usually excluded from therapeutic plans because of their oppressive outlook. We experienced two patients with Stage IV gallbadder cancer who had undergone intra-aortic infusion chemotherapy and experienced its tumoricidal effects. By keeping the tip of the catheter in the aorta at the Th 9-10 level, we intended to improve the efficiency of drug delivery to both primary lesion and para-aortic metastatic lymph nodes. The anti-cancer drugs employed were gemcitabine (day 3, 9, 1,000 mg/m2/30 min) and low-dose CDDP (day 1-5, day 8-12, 5 mg/30 min) combined with 5-FU (day 1-5, day 8-12, 250 mg/24 h). Day 15-21 was the treatment-free time for recovery from drug toxicities. Since this regimen was well tolerated, the patients could undergo this plan repeatedly. The evidence on CT scans or cholangiography revealed remarkable regression of both primary tumor and metastatic lymph nodes, or resolution of the biliary obstruction. The survival periods from the induction of the treatment were 12 and 14 months, respectively. Thus intra-aortic infusion chemotherapy may be beneficial for the treatment of gallbladder cancer associated with para-aortic lymph node involvement.
authors.affiliation: Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
authors.forename: Yoshihira
authors.initials: Y
authors.lastname: Shimada
authors.forename: Gaku
authors.initials: G
authors.lastname: Matsumoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Koji
authors.initials: K
authors.lastname: Tsurta
authors.forename: Atsuake
authors.initials: A
authors.lastname: Okamoto
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001011:Aorta; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005706:Gallbladder Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D005472:Fluorouracil; D000093542:Gemcitabine