Intra-arterial infusion of 5-fluorouracil, leucovorin, epirubicin and carboplatin (FLEC regimen) in unresectable pancreatic cancer: results of a ten-year experience.
The final results of a new regimen given intra-arterially for unresectable pancreatic cancer (UPC) are presented.


METHODS
From January 1994 to January 2006, 5-fluorouracil 1,000 mg/m2, leucovorin 100 mg/m2, epirubicin 60 mg/m2 and carboplatin 300 mg/m2 were administered every 3 weeks into the celiac axis (CA) angiografically (FLEC regimen) to 211 patients with UPC.


RESULTS
Seven hundred and sixty-four cycles were administered. Grade 3-4 hematological toxicity was observed in 24%; ematemesis in 4%; grade 3 gastrointestinal toxicity in 3%; grade 3 alopecia in 15%. One sudden death, a pre-infarction angina and a transitory ischemic attack were observed. No complications related to the angiographic procedure took place, but three tunica intima dissections of the iliac artery occurred; 7.6% of patients with partial responses and 50.7% with stable disease were observed. Two hundred and one patients have died; median overall survival was 9.2 months: 10.5 and 6.6 for stage III and IV, respectively.


CONCLUSIONS
The FLEC regimen given intra-arterially is well-tolerated and effective in patients with UPC.
Mambrini
Andrea
A
Department of Oncology, Massa-Carrara City Hospital, Italy.
Sanguinetti
Franco
F
Pacetti
Paola
P
Caudana
Roberto
R
Iacono
Calogero
C
Guglielmi
Alfredo
A
Guadagni
Stefano
S
Del Freo
Alfonso
A
Fiorentini
Giammaria
G
Cantore
Maurizio
M
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D002445:Celiac Artery; D010478:Chemotherapy, Cancer, Regional Perfusion; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
D015251:Epirubicin; D016190:Carboplatin; D002955:Leucovorin; D005472:Fluorouracil