REGIONAL CHEMOTHERAPY WITH HEMOFILTRATION - A RATIONALE FOR A DIFFERENT TREATMENT APPROACH TO ADVANCED PANCREATIC-CANCER

Background/Aims: Since 1989, thirty-two patients with advanced, intra- abdominal pancreatic cancer were treated with regional chemotherapy in combination with extracorporeal hemofiltration. Patients and Methods: Eleven patients had locally advanced, unresectable cancer, and ten ha d advanced disease with liver metastases. Three patients had developed liver metastases following a radical resection. One patient had an in complete resection with Local residual disease, and a second had devel oped a local recurrence after a radical resection. One patient had an unresectable cystadenocarcinoma. Five patients had failed prior system ic therapies for unresectable pancreatic cancer. The patients underwen t 85 treatments with regional chemotherapy plus hemofiltration, an ave rage of 2.7 treatments per patient. Results: Of 21 patients treated pr imarily with regional chemotherapy plus hemofiltration, there were two complete responses (9%) and eight partial responses (38%), an overall total response rate of 47%. The average survival for patients with St age II/III localized, unresectable disease is 13 months and that for S tage IV unresectable disease with Liver metastases is 9 months. Conclu sions: Patients with recurrent disease following a radical resection o r having failed prior systemic therapies generally had no benefit from regional chemotherapy plus hemofiltration.