Treatment of non-resectable pancreatic cancer with intraperitoneal 5-FU and leucovorin IV

Aim: To explore the feasibility of intraperitoneal (IP) 5-fluorouracil (5-F U) and (IV) leucovorin for patients with advanced pancreatic carcinoma. Materials and Method: Thirty patients (I I men), median age 65 (range 36-74 years), with a non-resectable pancreatic carcinoma in stage III (n = 2) an d IV (n = 28) were treated with IP 5-FU 750-1000 mg/m(2) and leucovorin IV 100 mg/m(2) for 2 days every 3 rd week. Tumour effect was analysed with rep eated computed tomography (CT) scans, performance status was estimated with Karnofsky's index (KI) and morphine consumption, and toxicity assessed usi ng World Health Organization (WHO) criteria. Results: Median survival time was 7 months (range 0-21). There was no diffe rence in survival between patients with different grading, staging or tumou r size. Regional and systemic toxicity: The treatment was well tolerated, with no g rade III or IV complications or side-effects. The median KI showed a minor reduction during treatment. The median morphine consumption per 24 hours in creased from 0 mg (range 0-250) at inclusion, to 70 mg (range 0-540) at exc lusion. The median nadir (WBC) was 7.2 x 10(3)/mm(3) (range 5.2-18.8). All patients had abdominal discomfort and distension during IP installation. Conclusion: Intraperitoneal administration of 5-FU is feasible for patients with nonresectable pancreatic carcinoma. The treatment can induce a tempor ary stabilization of tumour growth and eventually prolong survival without adverse effects. (C) 2001 Harcourt Publishers Ltd.