DOSE ESCALATED WHOLE LIVER IRRADIATION W/HEPATIC ARTERIAL DRUG CHEMOTHERAPY

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。累及肝脏的神经内分泌肿瘤的死亡率很高。腹痛和类癌综合征（腹泻、潮红、喘息）在这种疾病中很常见。这些肿瘤通常是多血管的，这意味着它们具有非常好的血液供应，可以用于将化疗直接输送到肿瘤。将通过放射学技术放置肝动脉导管，以进入肿瘤血液供应进行治疗。在这项研究中，患者将通过肝脏肿瘤的血液供应接受化疗药物的组合。FUDR将通过连续动脉输注给药。链脲佐菌素也将通过肝动脉在3天内给药。在这12天的化疗输注期间，患者还将接受肝脏放射治疗。在研究期间，放射治疗的剂量将递增。停药8周后，患者将再次入院接受化疗栓塞。在化疗栓塞期间，肿瘤的血液供应被化疗和栓塞剂阻断。本研究的主要目的是确定什么剂量的全肝放射治疗可以安全地给予IA FUDR和链脲佐菌素。次要目标是确定治疗患者的缓解率。将密切监测患者的治疗肝损伤体征或症状。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Neuroendocrine tumors with tumor involvement of the liver are associated with a high death rate. Abdominal pain and carcinoid syndrome (diarrhea, flushing, wheezing) is very common with this disease. These tumors are generally hypervascular, meaning that they have a very good blood supply that can be used to deliver chemotherapy directly to the tumor. A hepatic arterial catheter will be placed by radiological techniques to access the tumor blood supply for this treatment. In this study patients will receive a combination of chemotherapy drugs via the blood supply to the tumor in the liver. FUDR will be given as a continuous arterial infusion. Streptozotocin will be given on 3 separate days as well via the hepatic artery. During this 12 day chemotherapy infusion patients will also receive radiation therapy to the liver. The dose of radiation therapy will be escalated during the study. After an 8 week break, patients will be re-admitted for chemoembolization. During chemoembolization the blood supply to the tumor is blocked with chemotherapy and an embolization agent. The primary goal of this study is to determine what dose of whole liver radiation therapy can safely be given with IA FUDR and Streptozotocin. A secondary goal is to determine the response rate in treated patients. Patients will be closely monitored for signs or symptoms of liver injury from treatments.