DOSE ESCALATED WHOLE LIVER IRRADIATION W/HEPATIC ARTERIAL DRUG CHEMOTHERAPY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 神经内分泌肿瘤累及肝脏的死亡率较高。腹痛和类癌综合征(腹泻、潮红、喘息)是这种疾病的常见症状。这些肿瘤通常是多血管的，这意味着它们有非常好的血液供应，可以用来直接将化疗输送到肿瘤。将通过放射学技术放置肝动脉导管，以获取肿瘤的血液供应。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将作为持续动脉输注给予。链脲佐菌素也将分3天经肝动脉给药。在这12天的化疗输液期间，患者还将接受肝脏放射治疗。放射治疗的剂量将在研究期间逐步增加。休息8周后，患者将再次入院接受化疗栓塞术。在化疗栓塞术中，肿瘤的血液供应被化疗和栓塞剂阻断。这项研究的主要目的是确定IA、FUDR和链脲佐菌素可以安全地给予全肝放射治疗的剂量。第二个目标是确定接受治疗的患者的应答率。将密切监测患者在治疗过程中是否有肝损伤的迹象或症状。

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.'