Combined Intraperitoneal Paclitaxel and Systemic Chemotherapy for Patients with Massive Malignant Ascites Secondary to Pancreatic Cancer: A Report of Two Patients

Intern Med. 2024 Jul 15;63(14):2015-2021. doi: 10.2169/internalmedicine.2191-23. Epub 2023 Dec 4.

Abstract

The prognosis of patients with peritoneal metastases from pancreatic cancer is poor, largely due to massive ascites, which precludes systemic treatment. Two patients with a poor performance status and malignant ascites were treated with cell-free and concentrated ascites reinfusion therapy followed by combined chemotherapy with intraperitoneal paclitaxel, intravenous gemcitabine, and nab-paclitaxel. These patients achieved a survival of 19 and 36 weeks with a relatively good quality of life. Combined intraperitoneal paclitaxel and systemic chemotherapy may provide effective palliative management for some patients with peritoneal metastases from pancreatic cancer.

Keywords: cell-free and concentrated ascites reinfusion therapy (CART); intraperitoneal chemotherapy; malignant ascites; paclitaxel; pancreatic cancer; peritoneal metastasis.

Publication types

  • Case Reports

MeSH terms

  • Albumins / administration & dosage
  • Albumins / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols* / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Ascites* / drug therapy
  • Ascites* / etiology
  • Deoxycytidine* / administration & dosage
  • Deoxycytidine* / analogs & derivatives
  • Gemcitabine*
  • Humans
  • Infusions, Parenteral
  • Paclitaxel* / administration & dosage
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / drug therapy
  • Peritoneal Neoplasms* / complications
  • Peritoneal Neoplasms* / drug therapy
  • Peritoneal Neoplasms* / secondary

Substances

  • 130-nm albumin-bound paclitaxel
  • Albumins
  • Deoxycytidine
  • Gemcitabine
  • Paclitaxel