The safety of implanting sustained release 5-fluorouracil during operation in patients with thoracic neoplasms
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Objective To investigate the safety of implanting sustained release 5-fluorouracil during operation for patients with tumor of the chest.Methods Eighty patients from January 8 to June 10 in 2008 were selected.Sustained release 5-fluorouracil was implanted in 40 cases with tumor of the chest during operation.Forty patients as control group underwent operation alone.The indexes of routine examination pre-and post-operation such as blood indexes,the function of heart,lung,liver and kidney,and the incidence of complications were compared.Results There were no significant differences of blood indexes and the function of heart,lung,liver and kidney between the two groups.There was more fluid drained in the group of sustained release 5-fluorouracil.Differences in other indexes were not found between the two groups.Conclusion Implanting sustained release 5-fluorouracil during operation is a safe and simple therapy with few side effects.Cite
Objective To evaluate the effects and safety of sustained-release fluorouracil intraperitoneal implants on advanced gastric cancer.Methods All 57 cases with advanced gastric cancer were studied retrospectively: 28 cases received the sustained-release fluorouracil implants and 1 month later underwent the conventional chemotherapy.29 cases did not received intraperitoneal chemotherapy and 1 month later underwent the conventional chemotherapy.The information were collected before the chemotherapy,include the detail the history,complete physical examination,preoperative routine examination,simultaneous observation of nausea and vomiting,fever,diarrhea,abdominal pain and other symptoms.After the operation,the incision healing,intestinal obstruction and other complications were observed.The past examination index was rechecked,and 2 years survival rate was recorded.Results There was no statistically different in the chemical peritonitis,incision infection and dehiscence of abdominal abscess,anastomotic leakage,adhesion intestinal obstruction between the two groups.The gastrointestinal reaction rate is higher in the treatment group than that in the control group(P0.05) but the reaction were mild.There was no statistically different in the bone marrow inhibition,abnormal liver function and renal function abnormalities between the two group(P 0.05).The difference in 2 years survival rate between the two groups was significant(P0.05).Conclusion The sustained-release fluorouracil intraperitoneal implants are safe and effective for the advanced gastric cancer.
Wound dehiscence
Gastrointestinal function
Bone marrow suppression
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Bronchial artery infusion therapy has been performed in a total of 27 patients by a selective catheterization technique chiefly as surgical adjuvant chemotherapy. A major antitumor agent chosen for this study was Mitomycin C.1 Mitomycin C, Kyowa Hakko Kogyo Co. Ltd., Tokyo, Japan. There was apparent tumor regression on the chest roentgenograms in 14 of 27 cases. The extent of tumor shrinkage ranged from 75% at maximum to 36% at minimum in 2 dimensional measurements on the x-ray films. The patients were treated 1 to 4 times in a period of 2 days to 2 weeks. Observation periods after final infusion were limited to the term of preoperation. Subjective complaints were improved by the treatment. No serious side effects and very few complications were experienced. The authors would like to point out that the extent of tumor shrinkage may be related to the frequency of the infusion, and distant survival rate seemed to be better with the patients who received cancer resection after having recurrent infusion than with the patients having only one infusion.
Mitomycin C
Bronchial artery
Infusion therapy
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Objective To evaluate the clinical effect and adverse reactions of endoscopic implantation of slow-release particles for the treatment of advanced gastrointestinal cancer.Methods Fifteen patients with advanced gastrointestinal tumor were chose.During the endoscopic procedure,slow-releasing were implanted densely into the tumors and infiltrated area,45-60 pieces of agents were injected,which containing an average dose of 100 mg 5-Fu.Liver and kidney function of patients were compared before and after treatment.Results Fifteen cases underwent implantation after treatment,2 cases was complete remission,5 cases were partial remission,6 cases were in stable and 2 cases were in progress.The effective rate was 80％.The endoscopy examination showed that the size of tumors reduced in various degrees at one month after the implantation.No hemorrhage or perforation was observed.Liver and kidney function were stable after implantation.Conclusions Endoscopic implantation of sustainedrelease chemotherateutic drug 5-Fu in treatment of advanced gastrointestinal cancer is a new means of treatment,which can improve symptoms and local tumor control rate of patients,there were no liver and kidney function damage or other adverse reactions.The method has little poisonous side effect and is a well-tolerated palliative treatment.
Key words:
Gastroenteric tumor; 5-Fu slow-release particles; Endoscopy implanted
Perforation
Gastrointestinal function
Gastrointestinal cancer
Endoscopic treatment
Liver function
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Objective: To evaluate the surgical treatment of esophageal or cardiac carcinoma with portal hypertension in 16 patients. Methods: The sixteen patients were classified as grade A(11 patients) or B (5 patients) by Child gradation. Three patients underwent splenectomy during the operation. The esophagogastric anastomotic sites were above aortic arch in 3 patients and below aortic arch in 7 patients and others in the neck. Results: Fifteen patients recovered smoothly, 1 patient died and 3 patients who underwent splenectomy during the operation recovered quite well. There was a postoperative complication in 7 patients. After following 7 to 60 months, 3 cases have lost. The survival rates of 1 year, 3 years and 5 years were 81. 2%, 56. 2% and 33. 3% respectively after operation. Conclusion: The surgical treatment for esophageal or cardiac carcinoma with portal hypertension is first choice. Keeping supporting liver function, correcting hypoproleinemia and hypersplenism may do patients good and hold the key of treatment. Patient with hy-persplenism should undergo splenectomy at operation.
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Abdominal cavity
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Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty‐seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery. There was no operative mortality. Thirteen infusion systems could not be used for chemotherapy due to dislodgement, early death and lack of follow‐up. FUdR was infused every two weeks. There were minor local complications like thrombosis of the system and dislodgement of the port. Toxic effects could be managed by reducing the dose. Response to chemotherapy was evaluated by survival, clinical condition, CEA, ultrasound and CT six months after onset of arterial chemotherapy. Ten/twenty‐three patients (43%) responded to therapy, eight of them died on the average 19 months after initial chemotherapy. Six patients were non‐responders, seven had stable disease. Five/ten patients developed extrahepatic metastases. Mean survival time was 13.1 months, mean interval until relapse 10.6 months.
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To investigate the postoperative adverse events and survival of patients with sustained-released fluorouracil implanted during operation.Data of 124 patients with advanced gastric cancer undergoing radical operation in Tianjin Medical University Cancer Institute and Hospital from January 2007 to January 2009 were analyzed retrospectively. All the patients were divided into two groups according to whether intra-operative fluorouracil was implanted or not. The treatment group(n=64) was implanted with fluorouracil in abdominal cavity after radical resection. The control group(n=60) did not receive fluorouracil implant in abdominal cavity after radical resection. Abdominal drainage fluid, temperature and adverse events within 15 postoperative days and 3-year survival were observed and compared between the two groups.Pathological findings of the two groups were similar. No statistical significances existed in abdominal drainage fluid, temperature and adverse events within 15 postoperative days(P>0.05). The 3-year survival rate was higher in treatment group(64.3% vs. 42.4%, P=0.018).Intra-operative sustained-released fluorouracil implants are safe and tolerable, and can improve the survival rate of patients with advanced gastric cancer.
Abdominal cavity
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Chemotherapy by intra-arterial infusion, using mitomycin C and 5-fluorouracil, was administered to six patients with cancer of the rectum. In three patients who presented initially with an inoperable rectal tumour, medication was infused through the inferior mesenteric artery. Tumour regression was documented in all three, allowing subsequent resection in two. Of three other patients with locally recurrent rectal cancer, none showed tumour regression after infusion, but two experienced substantial relief of perineal pain, with improvement in the quality of life. Unexpected complications occurred in the form of a reversible ischemic colitis in two patients and an arterioenteric fistula in a third.
Mitomycin C
Inferior mesenteric artery
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The prognosis for patients with unresectable gastric cancer is so poor that 50% survival time is no more than 3 months. A 58-year-old woman was admitted for advanced gastric cancer with multiple liver metastases. Preoperatively, she received hepatic arterial infusion of 75 mg/m2 of cis-platinum during abdominal angiography. As laparotomy revealed an unresectable gastric tumor of the classification H3P2N4S3, a catheter was introduced into the aorta at the level of the celiac axis via a branch of the right femoral artery and 10 mg of Mitomycin C was infused into the abdominal aorta through the catheter. Postoperative chemotherapy consisted of continuous intra-arterial infusion of 250 mg/day of 5-Fluorouracil for 14 days, followed by infusion of another 10 mg of Mitomycin C. Daily oral administration of 600 mg of tegafur was continued in the outpatient clinic. Three months after surgery, the primary and hepatic metastatic lesions had regressed by 76 and 88-98% on abdominal computed tomography and gastric fluoroscopy, respectively. The dimensions of the lesions remained unchanged for the subsequent two months, and their responses to the treatment were judged PR. Eight months after surgery, the patient is in good general condition.
Tegafur
Mitomycin C
Abdominal aorta
Left gastric artery
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Objective To preliminary explore and summarize the clinical nursing experience for esophageal cancer patients undergoing implantation of 5-fluorouracil( 5-FU) sustained release particles. Methods Total 12 patients with esophageal cancer were enrolled in the study. The 5-fluorouracilsustained release particles were directly implanted into the esophageal tumor tissue and the tumor interstitial matrix via endoscopic biopsy channel,7 tablets every time amount to 200 mg. Preoperative psychological nursing,perioperative coordination and postoperative observation of patient's condition was assessed. Results The success rate of 5-fluorouracil implantation was 100%. 2 cases were invalid with a total effective rate of 83. 3%. The efficacy was confirmed by endoscopy one month after the operation,the size of tumors contracted at some extent. Conclusion The implantation of 5-fluorouracilsustained release particles into the esophageal tumor tissue can increase the content of drugs around the tumors,reveals the superiority of targeted therapy. This method is a minimally invasive,safe and effective method with a low toxic and side-effect.
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