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Journal of Gastrointestinal Surgery
Erschienen in: Journal of Gastrointestinal Surgery 1/2017

15.09.2016 | 2016 SSAT Plenary Presentation

Role of Fluorouracil, Doxorubicin, and Streptozocin Therapy in the Preoperative Treatment of Localized Pancreatic Neuroendocrine Tumors

verfasst von: Laura Prakash, Priya Bhosale, Jordan Cloyd, Michael Kim, Nathan Parker, James Yao, Arvind Dasari, Daniel Halperin, Thomas Aloia, Jeffrey E. Lee, Jean Nicolas Vauthey, Jason B. Fleming, Matthew H. G. Katz

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 1/2017

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Abstract

Introduction

5-Fluorouracil, doxorubicin, and streptozocin (FAS) leads to a 39 % response rate in advanced pancreatic neuroendocrine tumors (pNETs). We sought to validate our hypothesis that preoperative FAS may facilitate resection of locoregionally advanced pNETs by reducing the anatomic extent of the primary tumor.

Patients

All patients who received FAS between 2000 and 2012 as initial therapy for a localized pNET were reviewed. Tumor size and vascular relationships were compared on pretreatment and posttreatment imaging studies to quantify treatment response.

Results

Twenty-nine patients received a median 4 cycles of FAS (range 2–15). Rates of RECIST progressive disease (PD), stable disease (SD), and partial response (PR) were 3, 90, and 7 %, respectively. An interface was observed between the tumor and a major mesenteric artery and/or vein in 19 (66 %) and 24 (83 %) patients, respectively; after therapy with FAS, 17 (59 %) and 22 (76 %) had persistent interface with artery and/or vein. Fourteen (48 %) patients underwent pancreatectomy, 7 (50 %) required vascular management, and 9 (64 %) operations were R0. The median overall survival of unresected and resected patients was 41 months (95 % CI, 16–66) and 112 months (95 % CI, 104–120) (P = 0.04).

Conclusions

Although patients receiving FAS for locoregionally advanced pNETs are unlikely to progress during systemic therapy, significant “downstaging” appears uncommon.
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Metadaten
Titel
Role of Fluorouracil, Doxorubicin, and Streptozocin Therapy in the Preoperative Treatment of Localized Pancreatic Neuroendocrine Tumors
verfasst von
Laura Prakash
Priya Bhosale
Jordan Cloyd
Michael Kim
Nathan Parker
James Yao
Arvind Dasari
Daniel Halperin
Thomas Aloia
Jeffrey E. Lee
Jean Nicolas Vauthey
Jason B. Fleming
Matthew H. G. Katz
Publikationsdatum
15.09.2016
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 1/2017
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3270-4

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