Intra-aortic stop-flow infusion (IASFI) with hypoxic abdominal perfusion (HAP) in UICC stage III/IV pancreatic carcinoma (PC): Report of a phase II study

G. Fiorentini, D. Poddie, S. Ricci, m. Leoni, M. Cantore, G. Graziani, C. Dazzi, G. Rossi, D. Guglielminetti, R. Roversi

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: PC in UICC stage III and IV is still a challenge for Cancer Medicine. Pharmacokinetic data of IASFI with C-14 labeled Mitomycin-C (MC) by Averbach and Sugarbaker have shown to increase the exposure of upper gastrointestinal tract tissues. IASFI with/without HAP have shown a significant activity in advanced PC (Aigner and Gailhofer). Hypoxemia in IASFI enhances MC cytotoxicity. These data have prompted us to plan the following study. Patients and Methods: 20 Pts with stage III/IV PC (12/8) were treated with AISFI + HAP. MC 25 mgr/sqm was diluted in 500 cc ns and given as IASFI (infusion time : 5 min). Aortic occlusion was maintained over 22 min. (med. 19 ± 5). HAP was maintained by a rolling pump at a flow rate of 200 ml/min. All Pts had already received a biliary drainage endoscopically or have been derivated surgically and the bilirubin was in the normal range. Response to therapy as defined by computed tomography was ascertained if a decrease in tumor masses diameters, decrease in density due to necrosis were present. All Pts had high CEA and Gica levels so response rate was also measured by a ≤ 30% reduction of both markers. Results: 17 Pts had significant reduction/disappearance of severe pain (10/7) with suspension of narcotics. Eleven Pts had a significant P.S. improvement (2-3 to 0). We reported 1 pathological CR, 1 CR 8 PRs, 4 SDs, 6 PDs at CT scan and 12 Pts had reduction (≤ 30%) in markers base line levels. The toxicity was haematological grade 3 in 6 Pts and grade ≤ in 10 Pts. We had left iliac artery dissection in 1 pt, EKG alterations 1 Pt, nausea and vomiting grade 2 in 7 Pts. The responses lasted 8 months (6.5 ± 4.5), the survival time was 12 months (9 ± 4.5) for responders and 3 months (2 ± 1) for non responders. Conclusion: PC responds to IASFI + HAP, high local drug exposure combined with hypoxia can induce a significant RR = 50%, decrease in markers level (60%), increase in P.S. (55%) and pain relief (85%).

Original languageEnglish
Pages (from-to)88-91
Number of pages4
JournalRegional Cancer Treatment
Volume9
Issue number2
Publication statusPublished - 1996

ASJC Scopus subject areas

  • Oncology
  • Pharmacology

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