Komplementärtherapie des nicht kurativ resektablen Pankreaskarzinoms*

Author(s): Kleef, R., Popa, C., Dziambor, H., Schrittwieser, G., Strama, H., Süße, B.

Abstract: Objektive: In most phase 2 trials in patients with pancreas cancer a median survival time with chemotherapy of not more than 4-4,5 month is reported worldwide; with a combined chemo/radiation therapy a median survival time of max. 10-11 month is shown. Attempts to define a treatment that reproducibly induces responses in even 20% of patients have not been successful. The symptomatic benefit-response rate is about 5%. The present study proposes a new approach for therapy.Materials and method: In a retrospective study 28 patients so far with surgically no totally resectable pancreatic carcinomas underwent a complex therapy. All patients received: 1. enzyme-therapy (Kreon®, Wobenzym®), 2. loco-regional hyperthermia (13.56 MHz radiofrequencies in combination with glucose-induced acidosis), 3. hormone therapy (Tamoxifen, LH-RH-Analoga), 4. immunomodulating agents (thymus-peptides, mistletoelectines, cimetidine, prostaglandine-antagonists), 5. differentiating agents (vitamine A-E-palmitate H.D., alpha-hydroxycholecalciferol, coumarines). Some patients in progress under this regimen were treated with 5-FU, Mitomycin C, (*-Interferon, combined with loco-regional hyperthermia.Results: Median overall survival was 12 months. Most patients experienced partially excellent improvement in life quality (gain of appetite and weight, pain relief, improvement in general condition) and clinical criteria (reduction of jaundice and tumor mass, destruction of metastatic focuses, clinical chemistry and tumor marker CEA and CA 19-9 improvement).Conclusion: The results of this retrospective study ask for further studies in multicenter prospective randomized trials. Treatment protocol will define a multifactorial rather than a single acting approach.

Keyword(s): Pankreaskarzinom

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