Læknablaðið - 15.11.1982, Blaðsíða 46

284
LÆKNABLAÐID
fluorouracil, adriamycin, mytomycin and streptozo-
tocin (FAM-S). Three schedules with escalating
doses) were investigated. Infusions were repeated
every four weeks for two courses, and in responding
and stable patients i.v. FAM-S was continued.
Twelve (12) patients had measurable disease, and
in this group one complete response and seven
partial responses occurred. Median duration of
response was 6+ months and median survival of all
patients was 5.2 months. Four patients had catheter
related complications (emboli 3, sepsis 1). Hemato-
logic and gastrointestinal toxicity was minimal.
Celiac artery infusion with 5-FU, ADR, MTC and
STZ (FAM-S) in locally extensive and metastatic
adenocarcinoma of the pancreas and ampulla of
Vater is a relatively simple procedure associated
with low incidence of serious complications and
toxicity, but a higher response rate than previously
reported. Induction of response with CAI and
subsequent maintenance therapy with intravenous
chemotherapy is under investigation.
GASTRIC CANCER. A REVIEW OF 187 CASES
Jón Níelsson, Gunnar H. Gunnlaugsson, Pórarinn
Guðnason og Friðrik Einarsson, Borgarspítalinn,
Reykjavík.
187 consecutive cases of carcinoma of the stomach
that received primary treatment at Borgarspitalinn
in a 13 year period, 1968-1980, were reviewed. The
diagnosis was verified by histology or at laparotomy
in over 96 % of the cases. The follow-up was 100 %.
The highest incidence was in the seventh and eighth
decades of life. Men were twice as many as women.
The most common symptoms were pain (56 % of
patients), anorexia and nausea (50 %), asthenia
(40 %), weight loss more than 5 kg (37 %), epigastri-
al fullness (35 %), anaemia under lOg % (32 %) and
vomiting (29 %).
Although ninety per cent of the patients under-
went laparotomy, resection for cure was possible in
only 48 % of the total number of admitted cases.
Palliative procedures of some kind were done in
26 %. Of 89 operations intended for cure 54 were
distal resections, 11 esophagogastric resections, 18
total gastrectomies and 6 more extensive proce-
dures. The surgical mortality for these operations
was 3,6 %, 9 %, 11 % and 50 % respectively.
Even in cases resected for cure the cancer was far
advanced in most instances with serosal involve-
ment, positive lymph nodes or both in 75 %.
Positive lymph glands and invasion of serosa were
present together in 52 %. This was reflected in the 5
year survival rate for resections intended for cure
which was 19% as calculated by the actuarial
method. If surgical deaths are excluded this survival
rate is 21 %. The overall 5 year survival for the total
group of 187 was 8,6 %.
There was increase in the number of curative
resections from 37 % in the first 7 years of the
period (89 cases) to 57 % in the last six years (98
cases) which was statistically significant. Survival is
compared to that reported recently by others esp.
from the Scandinavian countries.
HEPATIC ARTERY INFUSION WITH
5-FLUOROURACIL AND MITOMYCIN-C IN
METASTATIC COLORECTAL CARCINOMA,
PHASE II STUDY
Ásgeir Theodórs, Ronald M. Bukowski, Ian
Lavery, James S. Hewlett, Robert B. Livingston og
Edward Buonocore. Departments of Hematology
and Medical Oncology, Colon and Rectal Surgery,
and Diagnostic Radiology, Cleveland Clinic
Foundation, Cleveland, Ohio 44106.
Thirty-two patients with measurable metastatic
colorectal carcinoma were treated with hepatic
artery infusion (HAI) employing 5-fluorouracil (5-
FU) and mitomycin-C (mito-C). Catheters were
placed percutaneously via the femoral artery. Two
schedules were employed: (I) 5-FU 1,200 mg/m2 IA
(Dl-4) and mito-C 8 mg/m2 IA (Dl+4); (II) 5-FU
1,200 mg/m2 IA (Dl-6) and mito-C 8 mg/m2 IA
(D1 + D4). Courses were repeated every four weeks.
Thirty patients were evaluable, 22 received schedule
1 and 8 patients schedule II. Complete response
occurred in two patients (6.7 %) and partial respon-
se in 13 patients (43.3 %). Five patients (16.7 %) had
minimal regression. The overall response rate was
66.7%. Median survival of all patients was 11.2
months. Median survival of responders and nonre-
sponders was 12.4 months and 4.6 months, respec-
tively (p<.05). No differences in response rates,
duration of response or survival occurred between
the two schedules. Toxicity was moderate to severe,
and morbidity of HAl was minimal. Intermittent
HAI of 5-FU and mito-C is a well tolerated
treatment modality associated with few serious
complications. The response rate, duration of re-
sponse and the survival is comparable to continuous
HAI infusion of 5-FU or floxuridine (FUDR). The
role of mito-C in the treatment modality is unclear
and needs further evaluation.
Útdrættir úr erindum bárust ritstjórn 14/01/1982.