1999 Fiscal Year Final Research Report Summary
Induction of long-term remission in advanced malignant abdominal tumors with percutaneous isolated organ chemoperfusion
| Project/Area Number |
09470267
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Kobe University |
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Principal Investigator |
GU Eisei Kobe University, School of Medicine, First department of Surgery, Associate Professor, 医学部, 助教授 (40195615)
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| Co-Investigator(Kenkyū-buntansha) |
IWASAKI Takeshi Kobe University, School of Medicine, First department of Surgery, Medical staff, 医学部・附属病院, 医員
TOMINAGA Masahiro Kobe University, School of Medicine, First department of Surgery, Assistant Professor, 医学部・附属病院, 助手 (70188796)
KURODA Yoshikazu Kobe University, School of Medicine, First department of Surgery, Professor, 医学部, 教授 (70178143)
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| Project Period (FY) |
1997 – 1999
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| Keywords | Percutaneous isolated organ chemoperfusion / Venous isolation and charcoal hemoperfusion / High-dose chemotherapy |
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| Research Abstract |
We have already established a new system for high-dose intraarterial chemotherapy with complete venous isolation and charcoal hemoperfusion in an attempt to maximize tumor drug delivery and at the same time, to minimize systemic toxicity. The purpose of this project was to develop multimodal treatment strategies for malignant abdominal tumors in the liver, the pancreas, and the pelvis. As for the liver tumors, from the clinical trials using percutaneous isolated hepatic perfusion (PIHP), we have confirmed that repeated treatments on the same patient further expand the therapeutic index of this treatment compared with single treatment. In patients with advanced hepatocellular carcinoma (HCC-stageIVA), the results indicated that complete plus partial response rates reached 63% and that 5-year survival rate increased to 30%. Moreover, based on our findings, we initiated randomized study of the preventive utility of PIHP for the patients with high risks of recurrence after resection of HCC
… More
. Now, our data showed that PIHP after resection remarkably reduced the recurrence rate and improved the tumor free survival. In addition, we have performed reduction surgery of HCC combining with PIHP for the patients who had unresectable tumors until now. The reduction surgery combining PIHP has resulted in increasing resection rate and survival rate of advanced HCC. While, we have also treated 8 patients with colorectal hepatic metastases using PIHP. We have introduced a new treatment protocol combining repeated PIHP as the inductive for these patients and have intermittent infusions as the maintenance therapy for these patients and have shown the efficacy of PIHP for the disease. Relating to the pancreatic cancer, in which multiple liver metastases were common, we have initiated a new trial of PIHP as the prophylactic treatment against liver metastases. On the other hand, we have initiated clinical trial of pelvic chemoperfusion with infrarenal inferior vena caval isolation and charcoal hemoperfusion (IVCI-CHP) for advanced uterine cancer. A protocol with pelvic chemoperfusion as a neoadjuvant chemotherapy was designed to achieve down-staging of advanced uterine cancer and those results confirmed us the effectiveness of this treatment for pelvic tumors. Recently we have also tried PIHP with peripheral blood stem cell transplantation for the purpose of super high dose chemotherapy. Based on these results, we concluded that our methods offers an effective therapeutic option for patients with malignant abdominal tumors. Less
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