DOSE ESCALATED WHOLE LIVER IRRADIATION W/HEPATIC ARTERIAL DRUG CHEMOTHERAPY

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。累及肝脏的神经内分泌肿瘤与高死亡率相关。腹痛和类癌综合征（腹泻、潮红、喘息）在本病中很常见。这些肿瘤通常是血管丰富的，这意味着它们有很好的血液供应，可以用来直接向肿瘤输送化疗。肝动脉导管将通过放射技术放置，以进入肿瘤的血液供应。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。链脲佐菌素将在3天内通过肝动脉注射。在这12天的化疗输注期间，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，患者将再次入院进行化疗栓塞。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IA FUDR和链脲佐菌素联合全肝放射治疗的安全剂量。第二个目标是确定治疗患者的反应率。将密切监测患者因治疗引起的肝损伤的体征或症状。

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.