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  • REGIONAL CHEMOTHERAPY  (2)
  • CELL LUNG-CANCER  (1)
Keywords
  • 1
    Keywords: SURVIVAL ; carcinoma ; CELL LUNG-CANCER ; COMBINATION ; Germany ; THERAPY ; DIAGNOSIS ; COHORT ; TIME ; PATIENT ; treatment ; chemotherapy ; TISSUE FACTOR ; SAFETY ; pancreatic carcinoma ; RANDOMIZED-TRIAL ; GEMCITABINE ; PHASE-III ; DRUG-DELIVERY ; REGIONAL CHEMOTHERAPY ; pancreatic ; RETROSPECTIVE ANALYSIS ; INTRAARTERIAL CHEMOTHERAPY ; low dose ; retrospective ; ARTERIAL INFUSION ; BLOOD-COAGULATION ; LEUKEMIA GROUP-B ; VITAMIN-K-ANTAGONISTS ; warfarin
    Abstract: Objective. To report the effect of regional combination chemotherapy in a cohort of patients with inoperable pancreatic carcinoma treated with or without low-dose warfarin. Material and methods. A retrospective analysis was performed on 180 patients with pancreatic carcinoma. Patients received one of seven regimens of chemotherapy. Unrelated to the type of chemotherapy, some patients received 1.25 mg warfarin daily. The primary end-point was median survival. Results. Treatment with warfarin resulted in improved median survival from the start of regional therapy ( warfarin versus no warfarin: 5.0 versus 2.3 months, n = 111 versus 69; p 〈 0.0001). This effect was not dependent on the type of chemotherapy used. Among the seven regimens examined, the one consisting of regional gemcitabine and mitomycin-C with systemic gemcitabine was associated with the longest median survival of 5.1 months from the start of regional therapy ( p = 0.006) and 12.7 months from diagnosis. This regimen combined with warfarin was associated with improved median survival ( 7.1 months, n = 32). Conclusions. Treatment with low-dose warfarin improved survival irrespective of the chemotherapy received. Of the regimens examined, the combination of regional gemcitabine and mitomycin-C with systemic gemcitabine was associated with the longest survival time. Survival was increased further by the addition of warfarin. These data provide a rationale, based on safety and efficacy, for a definitive study on the use of warfarin and combined regional and systemic chemotherapy in patients with pancreatic carcinoma
    Type of Publication: Journal article published
    PubMed ID: 16938724
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  • 2
    Keywords: CANCER ; IN-VITRO ; SURVIVAL ; carcinoma ; Germany ; THERAPY ; SUPPORT ; COHORT ; liver ; PATIENT ; NO ; chemotherapy ; drug delivery ; TISSUE FACTOR ; pancreatic carcinoma ; FEASIBILITY ; MOLECULAR-WEIGHT HEPARIN ; GEMCITABINE ; THERAPIES ; PHASE-III ; GRADE ; prospective studies ; REGIONAL CHEMOTHERAPY ; methods ; prospective ; prospective study ; ANEMIA ; VENOUS THROMBOEMBOLISM ; ARTERIAL INFUSION ; BLOOD-COAGULATION ; warfarin ; systemic
    Abstract: Aims: The aim is to prospectively examine the effect of regional gemcitabine and mitomycin-C with systemic gemcitabine together with warfarin in patients with inoperable pancreatic carcinoma, and compare the effect to systemic gemcitabine alone. Methods: Seventeen patients received 1.25 mg of warfarin daily, gemcitabine 800 mg/m(2) on day I and mitomycin-C 8 mg/m(2) on day 2 regionally and gemcitabine 800 mg/m(2) on day 14 peripherally. The cycle was repeated every 4 weeks. Results: Median survival since presentation was 6.8 months, while median total survival was 9.6 months. Excluding the 3 patients who died before receiving any therapy, the median survival since presentation resulted in 10.7 months and the median total Survival, 12.7 months. One patient developed bleeding that required transfusion and 2 patients developed anemia (Grades III/IV). Comparing these data to historical controls of large cohorts supports the notion that this regimen offers a viable alternative to systemic gemcitabine alone. Conclusion: A regimen consisting of regional gemcitabine and mitomycin-C with systemic gemcitabine and low-dose warfarin compares favorably to the gold standard of systemic gemcitabine. These data suggest the feasibility of a large prospective study on the use of warfarin and combined regional and systemic chemotherapy in patients with pancreatic carcinoma
    Type of Publication: Journal article published
    PubMed ID: 18836621
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