Endoscopy 2007; 39(6): 530-534
DOI: 10.1055/s-2007-966353
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided interstitial chemotherapy in the pancreas: results in a canine model

S.  Sun1 , S.  Wang1 , N.  Ge1 , T.  Lei1 , Q.  Lu1 , Z.  Zhou1 , A.  Yang2 , Z.  Wang3 , M.  Sun4
  • 1Endoscopy Center, Shengjing Hospital, China Medical University, Shenyang, Liaoning Province, China
  • 2Peking Union Medical College Hospital, Beijing, China
  • 3The China PLA General Hospital, Beijing, China
  • 4Endoscopy Center, The First Hospital of China Medical University, China
Further Information

Publication History

submitted 28 July 2006

accepted after revision 20 December 2006

Publication Date:
06 June 2007 (online)

Background and study aim: Interstitial chemotherapy using surgically implanted, biodegradable polymers has been reported. Our aim in this study was to investigate the feasibility and safety of endoscopic ultrasound- (EUS-) guided interstitial chemotherapy of the pancreas in a canine model.

Materials and methods: A therapeutic 19-gauge needle with a large channel was inserted into the pancreas under EUS guidance. The polymers for sustained intratumoral release of 5-fluorouracil were implanted into the tissue by the needle. After 14 days of clinical observation, the animals were sacrificed and the tissue response to the local chemotherapy was examined.

Results: All the polymers were implanted successfully and no implant migration occurred. Localized tissue fibrous necrosis was achieved in the pancreas, without significant complications. The apoptotic index of the tissue within 1 cm of the focus increased. Biochemical parameters were normal in all the dogs.

Conclusions: EUS-guided implantation of polymers is a safe, simple, and minimally invasive technique for interstitial chemotherapy in the pancreas.

References

  • 1 Berrada M, Yang Z, Lehnert S. Tumor treatment by sustained intratumoral release of 5-fluorouracil: effects of drug alone and in combined treatments.  J Radiat Oncol Biol Phys. 2002;  54 1550-1557
  • 2 Yamanaka H, Imai K, Mashimo T. et al . Fundamental study on the implantable LH-RH agonist/polymer and its use in a randomized trial for prostate cancer.  Prog Clin Biol Res. 1990;  357 135-143
  • 3 Fournier C, Hecquet B, Bouffard P. et al . Experimental studies and preliminary clinical trial of vinorelbine-loaded polymeric bioresorbable implants for the local treatment of solid tumors.  Cancer Res. 1991;  51 5384-5391
  • 4 Arica B, Calis S, Kas H. et al . 5-Fluorouracil encapsulated alginate beads for the treatment of breast cancer.  Int J Pharm. 2002;  242 267-269
  • 5 Tomita T. Interstitial chemotherapy for brain tumors: review.  J Neurooncol. 1991;  10 57-74
  • 6 Brem H, Piantadosi S, Burger P C. et al . Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group.  Lancet. 1995;  345 1008-1012
  • 7 Brem H, Mahaley Jr M S. et al . Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas.  J Neurosurg. 1991;  74 441-446
  • 8 Bergenfeldt M, Albertsson M. Current state of adjuvant therapy in resected pancreatic adenocarcinoma.  Acta Oncol. 2006;  45 124-135
  • 9 Czito B G, Hong T J, Cohen D P. et al . A phase I study of eniluracil/5-FU in combination with radiation therapy for potentially resectable and/or unresectable cancer of the pancreas and distal biliary tract.  Cancer Invest. 2006;  24 9-17
  • 10 Maffuz A, Bustamante F de , Silva J A, Torres-Vargas S. Preoperative gemcitabine for unresectable, solid pseudopapillary tumor of the pancreas.  Lancet Oncol. 2005;  6 185-186
  • 11 Wilkowski R, Thoma M, Bruns C. et al . Chemoradiotherapy with gemcitabine and continuous 5-FU in patients with primary inoperable pancreatic cancer.  JOP. 2006;  7 349-360
  • 12 Bhutani M S. Endoscopic ultrasonography: new developments and interesting trends.  Endoscopy. 2004;  36 950-956
  • 13 Giovannini M. Ultrasound-guided endoscopic surgery.  Best Pract Res Clin Gastroenterol. 2004;  18 183-200
  • 14 Chang K J, Nguyen P T, Thompson J A. Phase I clinical trial of allogeneic mixed lymphocyte culture (cytoimplant) delivered by endoscopic ultrasound-guided fine-needle injection in patients with advanced pancreatic carcinoma.  Cancer. 2000;  88 1325-1335
  • 15 Hecht J R, Bedford R, Abbruzzese J L. et al . A phase I/II trial of intratumoral endoscopic ultrasound injection of ONYX-015 with intravenous gemcitabine in unresectable pancreatic carcinoma.  Clin Cancer Res. 2003;  9 555-561
  • 16 Chan H H, Nishioka N S, Mino M. et al . EUS-guided photodynamic therapy of the pancreas: a pilot study.  Gastrointest Endosc. 2004;  59 95-99
  • 17 Goldberg S N, Mallery S, Gazelle G S, Brugge W R. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model.  Gastrointest Endosc. 1999;  50 392-401
  • 18 Yong A A, Roberts S A. Interventional endoscopic ultrasound.  Clin Radiol. 2003;  58 32-43
  • 19 Klapman J B, Chang K J. Endoscopic ultrasound-guided fine-needle injection.  Gastrointest Endosc Clin N Am. 2005;  15 169-177
  • 20 Gan S I, Thompson C C, Lauwers G Y. et al . Ethanol lavage of pancreatic cystic lesions: initial pilot study.  Gastrointest Endosc. 2005;  61 746-752
  • 21 Jurgensen C, Schuppan D, Neser F. et al . EUS-guided alcohol ablation of an insulinoma.  Gastrointest Endosc. 2006;  63 1059-1062
  • 22 Sun S, Qingjie L, Qiyong G. et al . EUS-guided interstitial brachytherapy of the pancreas: a feasibility study.  Gastrointest Endosc. 2005;  62 775-779
  • 23 Sun S, Xu H, Xin J. et al . Endoscopic ultrasound-guided interstitial brachytherapy of unresectable pancreatic cancer: results of a pilot trial.  Endoscopy. 2006;  38 399-403

S. Sun, MD

Shengjing Hospital

China Medical University

Sanhao Street 36

Shenyang

Liaoning Province

China 110004

Fax: +86-24-23892617

Email: Sunsy@cmu2h.com