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CardioVascular and Interventional Radiology
Erschienen in: CardioVascular and Interventional Radiology 3/2006

01.06.2006

Evaluation of the Efficacy of Combined Continuous Arterial Infusion and Systemic Chemotherapy for the Treatment of Advanced Pancreatic Carcinoma

verfasst von: O. Ikeda, S. Kusunoki, K. Kudoh, H. Takamori, T. Tsuji, K. Kanemitsu, Y. Yamashita

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 3/2006

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Abstract

Purpose

To evaluate the effects of combined continuous transcatheter arterial infusion (CTAI) and systemic chemotherapy in patients with advanced pancreatic carcinoma.

Methods

CTAI was performed in 17 patients with stage IV pancreatic cancer with (n = 11) or without (n = 6) liver metastasis. The reservoir was transcutaneously implanted with the help of angiography. The inferior pancreatic artery (IPA) was embolized to achieve delivery of the pancreatic blood supply through only the celiac artery. The systemic administration of gemcitabine was combined with the infusion of 5-fluorouracil via the reservoir. Treatment effects were evaluated based on the primary tumor size, liver metastasis, and survival time and factors such as tumor size, tumor location, and stage of pancreatic carcinoma; the embolized arteries were analyzed with respect to treatment effects and prognosis.

Results

A catheter was fixed in the gastroduodenal artery and splenic artery in 10 and 7 patients, respectively. Complete peripancreatic arterial occlusion was successful in 10 patients. CT showed a decrease in tumor size in 6 of 17 (35%) patients and a decrease in liver metastases in 6 of 11 (55%) patients. The survival time ranged from 4 to 18 months (mean ± SD, 8.8 ± 1.5 months). Complete embolization of arteries surrounding the pancreas was achieved in 10 patients; they manifested superior treatment effects and prognoses (p < 0.05).

Conclusion

In patients with advanced pancreatic cancer, long-term CTAI with systemic chemotherapy appeared to be effective not only against the primary tumor but also against liver metastases. Patients with successfully occluded peripancreatic arteries tended to survive longer.
Literatur
1.
Zimmerman SE, Smith FP, Scein PS (1981) Chemotherapy of pancreatic carcinoma. Cancer 47:1724PubMed
2.
Rosenberg JM, Welch JP, Macaulay WP (1985) Cancer of the head of the pancreas: An institutional review with emphasis on surgical therapy. J Surg Oncol 28:17
3.
Connolly MM, Dawson PJ, Michelassi F, Moosa AR, Lowenstein F (1987) Survival in 1001 patients with adenocarcinoma of the pancreas. Ann Surg 206:366PubMed
4.
Nagakawa T, Kobayashi H, Ueno K, Ohta T, Kayahara M, Miyazaki (1994) Clinical study of the lymphatic flow to pancreatic lymph nodes in carcinoma of the head of the pancreas. Cancer 73:1155PubMed
5.
Moertel CG, Engstrom P, Lavin PT, Gelber RD, Carbone PP (1979) Chemotherapy of pancreatic and gastric carcinoma: A controlled evaluation of combination of 5-FU with nitrosoureas and “lactones”. Surgery 85:509PubMed
6.
Hansen R, Quebbeman E, Ritch P, Chitamber C, Anderson T (1988) Continuous 5-FU infusion in carcinoma of the pancreas. Am J Med Sci 295:91PubMed
7.
Auerbach M, Wampler GL, Lockich JJ, Fryer D, Fryer JG, Ahlgren JD (1997) Treatment of advanced pancreatic carcinoma with a combination of protracted infusional 5-FU plus weekly cisplatin for pancreatic carcinoma. A Mid Atlantic Oncology Program Study. Ann Oncol 8:439PubMedCrossRef
8.
Carmichael J (1997) Clinical response benefit in patients with advanced pancreatic cancer. Role of gemcitabine. Digestion 58:503PubMed
9.
Casper ES, Green MR, Kelsen DP, et al (1994) Phase II trial of gemicitabine (2’2’-difluorodeoxycytidine) in patients with adenocarcinoma of the pancreas. Invest New Drugs 12:29PubMedCrossRef
10.
Rothenberg ML, Moore MJ, Cripps MC, et al (1996) A phase II trial of gemicitabine in patients with 5-FU refractory pancreas cancer. Ann Oncol 7:347PubMed
11.
Burris HA, Moore MJ, Andersen J, et al (1997) Improvements in survival and clinical benefits gemicitabine as first-line therapy for patients with advanced pancreatic cancer. J Clin Oncol 15:2403PubMed
12.
Muchmore JH, Perslan JE, George WJ (1996) Regional chemotherapy for inoperable pancreatic carcinoma. Cancer 78 (3 Suppl):664PubMed
13.
Miura K, Wada T (1981) Clinical effects of hyperthermia in advanced malignancy; Preliminary clinical results of combined 2450 megahertz microwave therapy and head of pancreas. Gastroenterol Surg 4:181
14.
Theodors A, Bukowski R, Hewlett J, Livingston RB, Weick JK (1982) Intermittent regional infusion of chemotherapy for pancreatic adenocarcinoma. Am J Clin Oncol 5:5555
15.
Ohigashi H, Ishikawa O, Imaoka S, et al (1996) A new method of intra-arterial regional chemotherapy with more selective drug delivery for locally advanced pancreatic cancer. Hepato-Gastroenterol 43:338
16.
Hiraska T, Watanabe E, Mochinaga M, et al (1984) Intraoperative radiation therapy for patients with pancreatic carcinoma. World J Surg 8:766
17.
Foo ML, Gunderson LL, Nagorney DM, et al (1993) Pattern of failure in grossly resected pancreatic ductal adenocarcinoma treated with adjuvant irradiation ± 5-fluorouracil. Int J Radiat Oncol Biol Phys 26:483PubMed
18.
Rosenberg JM, Welch JP, Macaulay WP (1985) Cancer of the head of the pancreas: An institutional review with the emphasis on surgical therapy. J Surg Oncol 28:217PubMed
19.
Niederhuber JE, Brennan MF, Menck HR (1995) The National Cancer Data Base Report on pancreatic cancer. Cancer 76:1671PubMed
20.
Splinter TAW, Obertop H, Kok TC, Jeekel J (1989) Adjuvant chemotherapy after resection of adenocarcinoma of the periampullary region and the head of the pancreas: A nonrandomized pilot study. J Cancer Res Clin Oncol 115:200PubMed
21.
Bakkevold KE, Amesjo B, Dahl O, Kambestad B (1993) Adjuvant combination chemotherapy (AMF) following radical resection of carcinoma of the pancreas and papilla of Vater: Results of a controlled, prospective randomized multicentre study. Eur J Cancer 29A:698PubMed
22.
Arbuck SG, (1990) Overview of chemotherapy for pancreatic cancer. Int J Pancreatol 7:209PubMed
23.
Wagener DJT, Hoogenraad WJ, Rougier P, et al (1996) Results of a phase II trial of epirubicin and cisplatin (EP) before and after irradiation and 5-fluorouracil in locally advanced pancreatic cancer. An EORTC GITCCG study. Eur J Cancer 32A:1310PubMed
24.
Connolly MM, Dawson PJ, Michelassi F, Moosa AR, Lowenstein F (1987) Survival in 1001 patients with adenocarcinoma of the pancreas. Ann Surg 206:366PubMed
25.
Muchmore JH, Preslan JE, George WJ (1996) Regional chemotherapy for inoperable pancreatic carcinoma. Cancer 78:664PubMed
26.
Douglass H (1993) Current approaches to multimodality management of advanced pancreatic cancer. Hepato-Gastroenterol 40:433
27.
Gudjonsson B (1995) Carcinoma of pancreas: Critical analysis of cost, results of resection, and the need for standardized reporting. J Am Coll Surg 181:483PubMed
28.
Zimmeman SE, Smith FP, Scein PS (1981) Chemotherapy of pancreatic carcinoma. Cancer 47:1724
29.
Gastrointestinal Tumor Study Group (1981) Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil. Cancer 48:1705
30.
Cantore M, Fiorentini G, Bassi C, et al (1997) Intra-arterial chemotherapy for stage-III/IV pancreatic cancer. Dig Surg 14:113
31.
Cohen L, Hendrickson FR, Lennox AJ, Kroc TK, Hatcher MA, Bennett BR (1996) Pancreatic cancer: Treatment with neutron irradiation alone and with chemotherapy. Radiology 200:627PubMed
32.
Palmer KR, Kerr M, Knowles G, Cull A, Carter DC, Leonard RCF (1994) Chemotherapy prolongs survival in inoperable pancreatic carcinoma. Br J Surg 81:882PubMed
33.
Evans TRJ, Lofts FJ, Mansi JL, Glees JP, Dalgleish AG, Knight MJ (1996) A phase II study of continuous-infusion 5-fluorouracil with cisplatin and epirubicin in inoperable pancreatic cancer. Br J Cancer 73:1260PubMed
34.
Smith L, Gazet J (1980) Intra-arterial chemotherapy for patients with inoperable carcinoma of the pancreas. Ann R Coll Surg Engl 62:208
35.
Ishikawa O, Ohigashi H, Sasaki Y, et al (1994) Liver perfusion chemotherapy via both the hepatic artery and portal vein to prevent hepatic metastasis after extended pancreatectomy for adenocarcinoma of the pancreas. Am J Surg 168:361PubMedCrossRef
36.
Ishida H, Makino T, Kobayashi M, Tsuneoka K (1983) Laparoscopic measurement of pancreatic blood flow. Endoscopy 15:107PubMed
37.
Aigner KR, Muller H, Basserman R (1990) Intra-arterial chemotherapy with MMC, CDDP and 5-FU for nonresectable pancreatic cancer. A phase II study. Reg Cancer Treat 3:1
38.
Muchmore JH (1995) Treatment of advanced pancreatic cancer with regional chemotherapy plus hemofiltration. Int J Pancreatol 7:209
39.
Theodors A, Bukowski R, Hewlett J, Livingston RB, Weick JK (1982) Intermittent regional infusion of chemotherapy for pancreatic adenocarcinoma. Phase I and II pilot study. Am J Clin Oncol 5:555PubMed
40.
Gansauge F, Link KH, Rilinger N, Kunz R, Beger HG (1995) Regional chemotherapy in advanced pancreatic carcinoma. Med Klin 90:501
41.
Link KH, Gansauge F, Rilinger N, Beger HG (1997) Celiac artery adjuvant chemotherapy. Results of a prospective trial. Int J Pancreatol 21:65PubMed
42.
Cantore M, Fiorentini G, Bassi C, et al (1996) Intra-arterial chemotherapy for locally advanced and metastatic pancreatic cancer. J Chemother 8:80
43.
Link KH, Gansauge F, Gorich J, Leder GH, Rilinger N, Beger HG (1997) Palliative and adjuvant regional chemotherapy in pancreatic cancer. Eur J Surg Oncol 23:409PubMedCrossRef
44.
Beger HG, Gansauge F, Buchler MW, Link KH (1999) Intra-arterial adjuvant chemotherapy after pancreaticoduodectomy for pancreatic cancer: Significant reduction in occurrence of liver metastases. World J Surg 23:946PubMedCrossRef
45.
Archer SG, Gray BN (1989) Vascularization of small liver metastases. Br J Surg 76:545PubMed
46.
Ackerman NB (1974) The blood supply of experimental liver metastases: IV, changes in vascularity with increasing tumor growth. Surgery 75:589PubMed
47.
Kemeny NE, (1995) Regional chemotherapy of colorectal cancer. Eur J Cancer 31A:1271PubMed
48.
Kerr DJ, McArdle CS, Ledermann J, et al (2003) Intrahepatic arterial versus intravenous fluorouracil and folinic acid for colorectal cancer liver metastases: A multicentre randomized trial. Lancet 361:368PubMed
49.
Rougier PH, Laplanche A, Haguier M, et al (1992) Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: Long-term results of a prospective randomized trial. J Clin Oncol 10:1112PubMed
50.
Griffin JF, Smally SR, Jewell W, et al (1990) Pattern of failure after curative resection of pancreatic carcinoma. Cancer 66:56PubMed
51.
Fortner JG, Klimstra DS, Senie RT, et al (1996) Tumor size is the primary prognosticator for pancreatic cancer after regional pancreatectomy. Am Surg 223:147
52.
Honma H, Doi T, Mezawa S, et al (2000) A novel infusion chemotherapy for the treatment of patients with advanced pancreatic carcinoma after vascular supply distribution via superselective embolization. Cancer 89:303
Metadaten
Titel
Evaluation of the Efficacy of Combined Continuous Arterial Infusion and Systemic Chemotherapy for the Treatment of Advanced Pancreatic Carcinoma
verfasst von
O. Ikeda
S. Kusunoki
K. Kudoh
H. Takamori
T. Tsuji
K. Kanemitsu
Y. Yamashita
Publikationsdatum
01.06.2006
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 3/2006
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-004-7177-1

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