Treatment of non-resectable pancreatic cancer with intraperitoneal 5-FU and leucovorin IV

Aim: To explore the feasibility of intraperitoneal (IP) 5-fluorouracil (5-FU) and (IV) leucovorin for patients with advanced pancreatic carcinoma. Materials and Method: Thirty patients (11 men), median age 65 (range 36–74 years), with a non-resectable pancreatic carcinoma in stage III (n=2) and IV (n=28) were treated with IP 5-FU 750–1000 mg/m2and leucovorin IV 100 mg/m2for 2 days every 3rd week. Tumour effect was analysed with repeated computed tomography (CT) scans, performance status was estimated with Karnofskyʹs index (KI) and morphine consumption, and toxicity assessed using World Health Organization (WHO) criteria. Results: Median survival time was 7 months (range 0–21). There was no difference in survival between patients with different grading, staging or tumour size. Regional and systemic toxicity: The treatment was well tolerated, with no grade III or IV complications or side-effects. The median KI showed a minor reduction during treatment. The median morphine consumption per 24 hours increased from 0 mg (range 0–250) at inclusion, to 70 mg (range 0–540) at exclusion. The median nadir (WBC) was 7.2×103/mm3(range 5.2–18.8). All patients had abdominal discomfort and distension during IP installation. Conclusion: Intraperitoneal administration of 5-FU is feasible for patients with nonresectable pancreatic carcinoma. The treatment can induce a temporary stabilization of tumour growth and eventually prolong survival without adverse effects.