This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Neuroendocrine tumors with tumor involvement of the liver are associated with a high death rate. Abdominal pain and carcinoid syndrome (diarrhea, flushing, wheezing) is very common with this disease. These tumors are generally hypervascular, meaning that they have a very good blood supply that can be used to deliver chemotherapy directly to the tumor. A hepatic arterial catheter will be placed by radiological techniques to access the tumor blood supply for this treatment. In this study patients will receive a combination of chemotherapy drugs via the blood supply to the tumor in the liver. FUDR will be given as a continuous arterial infusion. Streptozotocin will be given on 3 separate days as well via the hepatic artery. During this 12 day chemotherapy infusion patients will also receive radiation therapy to the liver. The dose of radiation therapy will be escalated during the study. After an 8 week break, patients will be re-admitted for chemoembolization. During chemoembolization the blood supply to the tumor is blocked with chemotherapy and an embolization agent. The primary goal of this study is to determine what dose of whole liver radiation therapy can safely be given with IA FUDR and Streptozotocin. A secondary goal is to determine the response rate in treated patients. Patients will be closely monitored for signs or symptoms of liver injury from treatments.'
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