Treatment of advanced Pancreas Cancer with Chemo-Thermotherapy

Friedrich R. Douwes, MD

Medical Director President of the German Society of Oncology (DGO)

Background: The results in the therapy of pancreas carcinoma remain disappointing. In nearly all cases the disease progresses, response rates of cytotoxic therapy are low and the 5-year survival rate amounts to 1%. The purpose of our treatment was to enhance the effectiveness of a cytostatic treatment with mitomycin c by combination with regional hyperthermia.

Patients and Methods: In a retrospective analysis 30 patients with advanced pancreatic carcinoma treated with a combined treatment with hyperthermia and chemotherapy were included. 5-fluorouracil (5-FU) (500 mg/m2) and calcium folinat (200 mg/m2) was given on day 1-5, mitomycin c (8 mg/m2) was injected on day 1. Regional capacitive radiofrequency hyperthermia (13.56 MHz) was applied on day 1, 3, 5 and 10, the duration was 60 minutes. The mean temperature of the tumor tissue was 420C – 440C. Treatment was repeated every 4 weeks until progression.

Results: The 30 patients received a total of 94 cycles (median 3, range 1-9) of combined therapy. According to the standard criteria, 1 patient had a complete remission, 10 patients (33,3%) had a partial remission; 12 (40%) had a stable disease. 7 patients (23,3%) did not respond to the therapy and showed progressive disease. Median survival time was 8 months (range 2-53 months), time to progression was 5.5 months (range 1-40 months). In a follow up study it could be shown that the treatment can be improved with even better results. We will present new data and some successfully treated cases.

Conclusion. The combined treatment shows a remarkable outcome in the therapy of advanced pancreatic carcinoma and is well tolerated. The data suggest further evaluation in randomized trials.

Key words Pancreatic carcinoma, Regional Hyperthermia, Palliative chemotherapy