Cytoreductive surgery combined with intraoperative chemo-hyperthermia and postoperative radiotherapy in the management of advanced pancreatic adenocarcinoma: Feasibility aspects and efficacy

Kouloulias, VE; Nikita, KS; Kouvaris, JR; Uzunoglu, NK; Golematis, VC; Papavasiliou, CG; Vlahos, LJ

dc.contributor.author	Kouloulias, VE	en
dc.contributor.author	Nikita, KS	en
dc.contributor.author	Kouvaris, JR	en
dc.contributor.author	Uzunoglu, NK	en
dc.contributor.author	Golematis, VC	en
dc.contributor.author	Papavasiliou, CG	en
dc.contributor.author	Vlahos, LJ	en
dc.date.accessioned	2014-03-01T01:16:16Z
dc.date.available	2014-03-01T01:16:16Z
dc.date.issued	2001	en
dc.identifier.issn	09441166	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/14006
dc.subject	Cytoreductive surgery	en
dc.subject	Intra-operative chemo-hyperthermia	en
dc.subject	Pancreatic cancer	en
dc.subject	Radiotherapy	en
dc.subject.other	antineoplastic antimetabolite	en
dc.subject.other	fluorouracil	en
dc.subject.other	adenocarcinoma	en
dc.subject.other	aged	en
dc.subject.other	article	en
dc.subject.other	clinical trial	en
dc.subject.other	feasibility study	en
dc.subject.other	female	en
dc.subject.other	human	en
dc.subject.other	hyperthermic therapy	en
dc.subject.other	intraoperative period	en
dc.subject.other	male	en
dc.subject.other	megavoltage radiotherapy	en
dc.subject.other	methodology	en
dc.subject.other	middle aged	en
dc.subject.other	multimodality cancer therapy	en
dc.subject.other	pancreas tumor	en
dc.subject.other	phase 1 clinical trial	en
dc.subject.other	phase 2 clinical trial	en
dc.subject.other	survival	en
dc.subject.other	treatment outcome	en
dc.subject.other	Adenocarcinoma	en
dc.subject.other	Aged	en
dc.subject.other	Antimetabolites, Antineoplastic	en
dc.subject.other	Combined Modality Therapy	en
dc.subject.other	Feasibility Studies	en
dc.subject.other	Female	en
dc.subject.other	Fluorouracil	en
dc.subject.other	Humans	en
dc.subject.other	Hyperthermia, Induced	en
dc.subject.other	Intraoperative Period	en
dc.subject.other	Male	en
dc.subject.other	Middle Aged	en
dc.subject.other	Pancreatic Neoplasms	en
dc.subject.other	Radiotherapy, High-Energy	en
dc.subject.other	Survival Analysis	en
dc.subject.other	Treatment Outcome	en
dc.title	Cytoreductive surgery combined with intraoperative chemo-hyperthermia and postoperative radiotherapy in the management of advanced pancreatic adenocarcinoma: Feasibility aspects and efficacy	en
heal.type	journalArticle	en
heal.identifier.primary	10.1007/s005340100026	en
heal.identifier.secondary	http://dx.doi.org/10.1007/s005340100026	en
heal.publicationDate	2001	en
heal.abstract	Background/Purpose. The aim of our study was to evaluate the feasibility and the efficacy of cytoreductive surgery (CS) with intraoperative chemo-hyperthermia in the management of advanced stage IVA (T4N0M0) pancreatic cancer. Methods. From August 1995 through March 1996, seven patients with unresectable adenocarcinoma of the pancreas underwent CS, with preoperative chemotherapy (5-fluorouracil [FU] for 96h), plus 45-Gy external beam postoperative irradiation with a 6-MeV linear accelerator (1.8Gy per fraction, 5 days per week). A single session of intraoperative hyperthermia was performed with a waveguide-type applicator operating at 433MHz, and temperature was measured by inserting a flexiguide needle catheter carrying a thermometry probe with three measuring points into the tumor. The tumor region was heated to 43°C-45°C for up to 60min, while 5-FU 500mg was injected simultaneously through the gastroduodenal artery into the splenic artery (intraoperative regional chemotherapy). Results. Postoperative recovery was uneventful for all patients. After the combined treatment, there was a significant decrease in the values of both serum carcinoembryonic antigen (CEA; P = 0.017, Wilcoxon test) and carbohydrate antigen (CA)19-9 (P = 0.016; Wilcoxon test), from 7.6 ± 1.5ng/ml CEA and 869.6 ± 126.9 U/ml CA to 3.5 ± 0.8ng/ml CEA and 104.7 ± 35.4 U/ml CA19-9. Moreover, there was a significant improvement (P = 0.016; Wilcoxon test) in Eastern Cooperative Oncology Group performance status, pain score, and body mass index. The median overall survival was 18.5 (SE, 1.8) months. Conclusions. Our preliminary clinical results suggest the tolerability and the considerable potential advantage of using cytoreductive resection with preoperative chemotherapy, intraoperative chemo-hyperthermia, and external beam postoperative radiotherapy for the management of advanced adenocarcinoma of the pancreas.	en
heal.journalName	Journal of Hepato-Biliary-Pancreatic Surgery	en
dc.identifier.doi	10.1007/s005340100026	en
dc.identifier.volume	8	en
dc.identifier.issue	6	en
dc.identifier.spage	564	en
dc.identifier.epage	570	en