Intraoperative radiation therapy and concurrent infusional 5-Fu chemotherapy pilot study for gastrointestinal malignancies

Purpose/Objective: This is a preliminary report of 5 patients diagnosed with locally advanced nonresectable pancreatic cancer who have achieved an excellent response in terms of quality of life, delay of local progression, and reduction of biomarker CA 19-9 aRer the infusion of colloidal 32p and administration of combined chumoradiotherapy.Methods: At our institution, a recently reported phase I trial using a unique method of intratumoral colloidal 32p delivery was completed.A phase H trial utilizing this method for nonresectable pancreatic cancer without metastases is currently in progress.Patients were initially given infusions of decadron followed by macroaggregated albumin and 30 mCi colloidal 32p to the interstitial space of the tumor by two infusions one week apart.Through this method, doses ranging from 750,000 to !,800,000 cGy were delivered.Following administration of colloidal 32p, external radiation to a dose of 6000 cGy minimum tumor dose, including regional lymph nodes, was given concomitantly with four intravenous infusions of 500 mg bolus 5-Fluorouracil on alternating days within the first two weeks after initiation of external radiation.