Intraperitoneal recombinant human endostatin combined with chemotherapy for refractory malignant ascites due to gastrointestinal cancer: a pilot study.
OBJECTIVE
To evaluate the efficacy, safety and consequent impact on quality of life of a combined-modality using intraperitoneal recombinant human endostatin, Endostar and chemotherapy in patients with refractory malignant ascites caused by gastrointestinal cancer.


METHODS
Patients received combined intraperitoneal therapy repeated 3 weeks, which consisted of 5-fluorouracil 600 mg/m2 and cisplatin 30 mg/m2 on day 1-3 followed by Endostar 60 mg on day 4.


RESULTS
A total of 18 patients were treated. The overall response rate was 55.6%, with a complete remission rate of 22.2%. The malignant ascites controlled rate was 77.8%. The median time to progression and overall survival was 2.6 and 4.9 months, respectively. Therapy-associated toxicities were generally mild to moderate treatment-related deaths. The mean Karnofsky performance status score was significantly improved from 59.4±2.49 at enrollment to 69.4±3.18 at 2 weeks after the first cycle of therapy (p=0.001). The mean score for overall ascites-associated symptoms was improved from 5.3±0.35 to 4.0±0.23 (p=0.004). Significant improvements of 6 individual symptoms were also observed.


CONCLUSIONS
The combined-modality using intraperitoneal Endostar and chemotherapy is effective and safe in selected patients with refractory malignant ascites due to gastrointestinal cancer and significantly improves patient's quality of life with encouraging survival, which merits further investigation.
Department of Radiation Oncology and Chemotherapy, The 1st Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
Sheng Liu
SL
Xue
Xia
X
Deng
Yang
Y
Liu
Hua Fang
HF
Su
Mei Long
ML
Hu
Cong Ying
CY
Xie
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001201:Ascites / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D043169:Endostatins / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D006801:Humans; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D011994:Recombinant Proteins / Q000008:administration & dosage
D043169:Endostatins; D011994:Recombinant Proteins