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Paper Information

Journal:   GOVARESH JOURNAL   FALL 2015 , Volume 20 , Number SUPPLEMENT; Page(s) 42 To 42.
 
Paper: 

EVALUATION OF EUS-GUIDED INTRATUMORAL GEMCITABINE THERAPY FOR ADVANCED UNRESECTABLE PANCREATIC CANCER: A PHASE 1 STUDY

 
 
Author(s):  ZAMANI FARHAD*, MOHAMMAD NEJAD MEHDI, SOHRAB MASUODREZA
 
* GASTROINTESTINAL AND LIVER DISEASE RESEARCH CENTER, IRAN UNIVERSITY OF MEDICAL SCIENCES
 
Abstract: 

Introduction: Pancreatic cancer is the fifth leading cause of cancer death worldwide. Desmoplastic reaction is a prominent pathologic feature of pancreatic cancer. We aimed to investigate whether direct delivery of chemotherapeutic agent into the tumor is safe and improves local control of pancreatic cancer.
Methods: Newly diagnosed patients with locally advanced, unresectable and non-metastatic pancreatic cancer were treated with two sessions of EUS-guided fine needle intratumoral injection (FNI) of gemcitabine (40 mg/ml), three months apart. The procedure was performed by single endosonographer (MM). The hematology and blood biochemistry laboratory tests were measured one day after gemcitabine injection and the patients were followed up clinically to assess toxicity.
Results: Twelve patients with pancreatic cancer (median age: 65.5; range: 44-82 years; 6 males) received intratumoral FNI of gemcitabine. A mean 3.1 of needle passes (range: 2-5) were made to inject mean total volume of 4.2 ml (range: 2-5 ml) at the first session corresponding to a mean 168 mg (range: 80 to 200 mg) of gemcitabine.
There was no adverse effect observed with intratumoral gemcitabine therapy. The survival rate at six month was 92% in intartumoral gemcitabine therapy group, and 48% in the control group (P: 0.01). None of the patients developed downstaging of the tumor.
Conclusion: EUS-guided intratumoral gemcitabineinjection is safe in pancreatic cancer.
The observed higher rate of 6-month survival with two sessions of intratumoral therapy suggests the short term benefit of this procedure. Further randomized controlled trials are needed to assess the efficacy of repeated intratumoral therapies at 3 months interval.

 
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