Multimodale komplementäre Therapie des fortgeschrittenen Pankreaskarzinoms

Zusammenfassung

In einer prospektiven Analyse wurden 46 Patienten mit weit fortgeschrittenen, chirurgisch nicht komplett resezierbaren Pankreaskarzinomen einer multimodalen komplementären Therapie unterzogen. Die Patienten wurden nach folgendem Schema behandelt: loko-regionale Radiofrequenz-Tiefenhyperthermie (13,56 MHz), Enzymtherapie (Kreon®, Wobenzym®), Hormontherapie (Tamoxifen, Flutamid, LH-RH-Analoga), immunmodulierende Agenzien (Thymuspeptide, Mistelextrakt, Cimetidin, Prostaglandin-Antagonisten), Differenzierungsfaktoren (Hochdosis Vitamin A-E-Palmitat, alpha-Hydroxycalciferol, 7-OH-Cumarin) und endogene Hyperexie mit einer gemischten bakteriellen Vakzine (Vaccineurin®). Einige Patienten im Progress unter dieser Therapie wurden mit 5-FU, Mitomycin C und α-Interferon in Kombination mit einer loko-regionalen Tiefenhyperthermie behandelt. Die mediane Überlebenszeit der Patienten unter dieser Therapie betrug 10,8 Monate; die 5-Jahresüberlebensrate betrug 9 %. Die meisten Patienten konnten eine deutliche Verbesserung der Lebensqualität (Verbesserung des Appetits, Gewichtszunahme, Verringerung der Schmerzen, Verbesserung des Allgemeinzustandes) erfahren und eine Verbesserung klinischer Kriterien (Reduktion der Tumormasse und metastatischer Filiae, Rückbildung von Aszites und Ikterus, Verbesserung klinischer Laborparameter, insbesondere der Tumormarker CEA und CA 19-9).

Summary

In a prospective study 46 patients with far advanced, surgically not totally resectable pancreatic carcinomas underwent a multimodal, complementary therapy. All patients received: loco-regional radiofrequency deep hyperthermia (13.56 MHz), enzyme-therapy (Kreon®, Wobenzym®), anti-hormonal therapy (tamoxifen, flutamid, LH-RH-Analoga), immunomodulating agents (thymus-peptides, mistletoe extract, cimetidine, prostaglandine-antagonists), differentiating agents (high-dose vitamin A-E-palmitate, alpha-hydroxycalciferol, coumarines), endogenous hyperpyrexia with a mixed bacterial vaccine (Vaccineurin®). Some patients in progress under this regimen were treated with 5-FU, Mitomycin C, α-Interferon, combined with loco-regional deep hyperthermia. Results: Median overall survival was 10.8 months with a 5-year-survival rate of 9 %. Most patients experienced partially excellent improvement in quality of life (gain of appetite and weight, pain relief, improvement in general condition) and clinical criteria (reduction of ascites, jaundice and tumor mass, destruction of metastatic focuses, clinical chemistry and decrease of tumor marker CEA and CA 19-9).

Schlüsselwörter

Pankreaskarzinom - multimodale Therapie - Komplementärtherapie - Hyperthermie - Enzymtherapie - Hormontherapie - Immuntherapie - Differenzierungstherapie

Keywords

pancreas cancer - multimodal therapy - complementary therapy - hyperthermia - enzyme therapy - hormone therapy - immunotherapy - differentiation therapy

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