Patients with gallbadder
cancer associated with remarkable lymph node involvement along the para-aortic region are usually excluded from therapeutic plans because of their oppressive outlook. We experienced two patients with Stage IV gallbadder
cancer who had undergone intra-aortic infusion
chemotherapy and experienced its tumoricidal effects. By keeping the tip of the
catheter in the aorta at the Th 9-10 level, we intended to improve the efficiency of
drug delivery to both primary lesion and para-aortic metastatic lymph nodes. The anti-
cancer drugs employed were
gemcitabine (day 3, 9, 1,000 mg/m2/30 min) and low-dose CDDP (day 1-5, day 8-12, 5 mg/30 min) combined with
5-FU (day 1-5, day 8-12, 250 mg/24 h). Day 15-21 was the treatment-free time for recovery from
drug toxicities. Since this regimen was well tolerated, the patients could undergo this plan repeatedly. The evidence on CT scans or cholangiography revealed remarkable regression of both primary
tumor and metastatic lymph nodes, or resolution of the biliary obstruction. The survival periods from the induction of the treatment were 12 and 14 months, respectively. Thus intra-aortic infusion
chemotherapy may be beneficial for the treatment of
gallbladder cancer associated with para-aortic lymph node involvement.