Objective: To examine the efficacy and safety of electrochemical therapy (ECT) in treatment of patients with unresectable carcinoma of the body and tail of pancreas.
Methods: A total of 18 patients (14 men and 4 women; mean age 57.7) with unresectable carcinoma of the body and tail of pancreas were treated by ECT between May 1989 and June 1996 in our hospital (group A). Another 16 patients (12 men and 4 women; mean age 60.3) were treated by ECT plus intraperitoneal chemotherapy between July 1996 and June 1999 (group B). In group B, ECT was used during the operation. Meanwhile, 300 mg calcium leucovorin (CF), 500 mg 5-FU and 200 mg carboplatin were injected weekly into the abdominal cavity through the implanted ports. Pain was determined by using a 10-point visual analog pain scale (VAS) before and after the treatment, life quality periodically assessed according to the 5-step scale system, and tumor size measured using CT or MRI.
Results: All the patients were followed up for 5-30 months (mean = 10 months), showing that there were no operative deaths and such complications such as pancreatic fistula and bleeding in both groups. The tumor size in both groups was decreased to some degree. Ascites in 4 of 6 cases in group B were well controlled, whereas there was no changes in 6 cases of ascites in group A. In group A, the VAS basal score was reduced from 7.4 +/- 1.7 before to 2.66 +/- 1.05 after the treatment and the peak VAS from 9.3 +/- 0.9 to 3.71 +/- 0.96 (P < 0.05). In group B, they were decreased from 7.5 +/- 1.5 to 2.17 +/- 1.23 and 9.2 +/- 0.9 to 3.4 +/- 1.13, respectively (P < 0.01). Significant reduction of VAS score persisted for over 3 months after ECT. The satisfaction rate in group B was 37.5%, 62.5% and 25% in 7 days, 1 month and 3 months, respectively.
Conclusions: ECT is a safe and effective procedure for treatment of unresectable carcinoma of the body and tail of pancreas and in relieving its pain and improving the life quality of patients. Supplementary injection of chemical drugs through drug delivery pump is helpful for control of ascites.