Endoscopic local injection of early gastric carcinoma with 5-fluorouracil

Abstract

We treated four patients who had early gastric carcinoma with weekly endoscopic local injections of 5-fluorouracil (5FU). In all four patients the lesions disappeared by endoscopic and biopsy examination within 12-18 weeks of treatment. None of the patients experienced side effects which are usually associated with oral or intravenous administration of 5FU. Two patients eventually underwent surgery. In one, a small focus of carcinoma was identified within the resected stomach; no evidence of carcinoma was found in the other. The remaining two patients have not submitted to surgery and are free of carcinoma by endoscopy for over 1 1/2 years. In this uncontrolled study, endoscopic local injection of 5FU appeared to be effective in treating early gastric carcinoma as assessed by endoscopic and histological criteria. Surgery remains the treatment of choice for early gastric carcinoma. However, further studies of endoscopic injection therapy are needed to determine whether this treatment is appropriate for patients with early gastric carcinoma who are not surgical candidates.

Endoscopic Chemotherapy with 5-Fluorouracil in Advanced Gastric Cancer

“…However, the results of previous reports [9][10][11][12][13] and the analysis of our cases led us to expect interesting benefits from this therapy in those patients in which surgery or systemic chemotherapy is contraindicated. Moreover, new frontiers in research could possibly be reached, by combining EC with conventional gastric cancer curative or palliative treatments, such as surgery, systemic chemotherapy, and radiotherapy.…”

“…The use of EC carried out by Kumayama in four patients with EGC produced a complete response without subsequent evidential lesions in either of the two patients who later decided to undergo surgery [11].…”

Intratumoral Administration of Methotrexate Bound to Activated Carbon Particles: Antitumor Effectiveness against Human Colon Carcinoma Xenografts and Acute Toxicity in Mice

“…Furthermore, in the case of patients with locally advanced cancer on whom neither surgical procedures can be performed nor systemic chemotherapy can be administered, the intratumoral injection of MTX-CH suppresses the tumor growth and prevents stenosis or bleeding, thus improving the quality of life of the patients. Endoscopic intratumoral administration of anticancer drugs is a low-invasive procedure and is useful for unresectable digestive tract cancer (Kuwayama et al, 1984;Cascinu et al, 1998). It can be expected that intratumoral administration of MTX-CH will be useful as one of the clinical tools in patients with colon cancer who cannot receive surgical treatment due to various reasons.…”

“…The LD 50 values of MTX-CH are 75 times higher than the efficacious dose of 30 mg/kg. The present results suggest that intratumoral administration of MTX-CH is useful for local therapy and the therapeutic dose of MTX-CH can be safely injected subcutaneously.Intratumoral administration therapy is useful for the patients with digestive tract cancer, who cannot receive surgical treatment due to a locally advanced unresectable tumor or with surgical risks such as cardiac diseases, aging, and so on (Kuwayama et al, 1984;Cascinu et al, 1998). However, locally injected drugs in aqueous solution form are rapidly absorbed through blood capillaries into the circulatory blood; therefore, they are not effective at the injected sites (Ballard, 1968).…”