RESUMO
BACKGROUND/AIMS: In an attempt to improve treatment protocols for advanced pancreatic cancer, the value of regional chemotherapy compared with systemic chemotherapy was investigated in this randomized study. METHODOLOGY: Fourteen patients with advanced non-resectable pancreatic adenocarcinoma were randomized receiving either systemic chemotherapy with mitomycin, mitoxanthrone and cisplatin (5pts.) or celiac axis infusion regional chemotherapy with SpherexR microembolization. In the systemic group one patient was stage III, four patients were stage IV, in the intraarterial group two patients were specified stage III and seven were stage IV. RESULTS: In the systemic group one stable disease and four progressive diseases were noted, in the regional group two stable diseases and seven partial responses were noted. Median survival was 11 weeks in the systemically treated patients versus 33 weeks in the patients treated with intraarterial infusion (p=0.001). One patient became resectable (R0). CONCLUSIONS: Performance status improved during regional chemotherapy whilst it steadily decreased in the patients treated systemically. The study was terminated at that point.
Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioterapia do Câncer por Perfusão Regional , Neoplasias Pancreáticas/tratamento farmacológico , Adenocarcinoma/sangue , Adenocarcinoma/mortalidade , Fosfatase Alcalina/sangue , Bilirrubina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/mortalidade , Estudos Prospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Fourty-five patients with progressive FIGO IIIc (36/45 pts.) and IV (9/45 pts.) ovarian cancer, who were in progression under prior cisplatin-based chemotherapy, were submitted to aortic infusion and stop flow infusion with the same drugs. 36/45 patients (80%) had four-quadrant and 9/45 patients (20%) had two-quadrant peritoneal carcinosis, 33/45 with severe ascites. Overall clinical response was 93%: 5/45 CR (11%), 21/45 PR (47%), 16/45 MR (35%). Complete resolution of ascites occurred in 9/33 patients (27%), a substantial reduction of ascites of more than 50% in 14/33 patients (43%). Median survival time was 12.5 months, median time to progression 8.6 months. Toxicity was minimal and in most patients performance and quality of life improved shortly after therapy.
