3 One cases of advanced pancreatic radiation hyperthermia chemotherapy was effective[Machine Translation] (放射線温熱化学療法が有効であった進行膵癌の一例)

Between December 1998 and May 2004, 18 pancreatic cancer patients with life expectancy longer than one month were treated with local hyperthermia (HT) using Thermotron RF-8 capacitive heating device (Osaka, Japan) in Nishide Hospital. There were: one patient with Stage II, 5 - Stage III, 11 - Stage IV, and one - with recurrent tumor. HT was combined with low dose chemotherapy (CT) in 16 cases, with radiotherapy (RT) - in 1, chemoradiotherapy (CRT) - in 1 case. Number of HT sessions ranged from 8 to 56, being delivered once or twice a week for 40-60 min. Power output ranged from 555 to 1565 W. An overall local response rate was 28 %, whereas QOL was improved in 61-66 %, depending on parameter, and median survival was 5.5 months. Case report. Patient, 74 y. old, male, was suspected to have a pancreatic tumor May, 2003. The diagnosis was finally confirmed as T4NoM1 pancreatic tumor, stomach metastases, ascitis (-), Stage IV. From June, 2003 chemotherapy with low dose gemcitabine (800 mg/m2) was initiated in K. N. Hospital. In December, 2003, patient had arrived to Nishide Hospital with purpose of combination of CT with local HT. Tumor markers were CEA - 68 ng/ml, CA 19-9 - 1328 ng/ml. From December 2003, HT was performed once a week, after CT, lasted for 40-60 min, with maximum power output of 744 W. Despite continuing of therapy, there was an increase of values of tumor markers in the blood, becoming CEA - 128 ng/ml, CA 19-9 - 2785 ng/ml in January, 2004 and 213 ng/ml, 3872 ng/ml, respectively, in February. Ascites had developed, and subjectively there was a worsening of symptoms. CT was then changed to CPT-ll (irinotecan) 70 mg/m2 bi-weekly. It worth to notice, that the dose chosen is 70 % from that recommended for employment in out-patient regimens. It resulted in dramatic decrease of tumor markers to CEA - 55 ng/ml, CA 19-9 - 1718 ng/ml in March, and 16.9 ng/ml, 320 ng/ml, respectively, in April. Ascites was not evident any longer as confirmed by tomography. Conventionally fractionated RT (total dose 54 Gy) was added in April-May, and tumor markers decreased to 8.3 ng/ml and 118 ng/ml, respectively. Tomography scans revealed tumor necrosis, and decrease in size estimated as PR, compared to scans taken in October, 2003. At present, patient continues to undergo HT+CT therapy with Grade 0-1 toxicity due to CPT-11. Conclusion. We suggest that combination of HT to CT and/or RT may be useful in management of pancreatic tumors, demonstrating palliation of sympto