Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Continuous Transarterial Infusion Chemotherapy with Gemcitabine and 5-Fluorouracil for Advanced Pancreatic Carcinoma

  • Published : 2012.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Pancreatic carcinoma is one of the most malignant tumors of the alimentary system, with relatively high incidence rates. The purpose of this study was to assess the efficacy and safety of two regimens for advanced pancreatic carcinoma: continuous transarterial infusion versus systemic venous chemotherapy with gemcitabine and 5-fluorouracil. Methods: Of the 48 patients with advanced pancreatic carcinoma receiving chemotherapy with gemcitabine and 5-fluorouracil, 24 received the selective transarterial infusion, and 24 the systemic chemotherapy. For the continuous transarterial infusion group (experimental group), all patients received gemcitabine 1000 mg/$m^2$, given by 30-minute transarterial infusion, on day 1 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. For the systemic venous group (control group), gemcitabine and 5-fluorouracil were infused through a peripheral vein, a dose of 1000 mg/$m^2$ gemcitabine being administrated over 30 min on days 1 and 8 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. The effectiveness and safety were evaluated after 2 cyclesaccording to WHO criteria. Results:The objective effective rate in transarterial group was 33.3% versus 25% in the systemic group, the difference not being significant (P=0.626). Clinical benefit rates(CBR) in the transarterial and systemic groups were 83.3% and 58.3%, respectively (P=0.014). The means and medians for survival time in transarterial group were higher than those of the systemic group (P < 0.005). at the same time, the adverse effects did not significantly differ between the two groups (P > 0.05). Conclusion: Continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic carcinoma, compared with systemic venous chemotherapy. Since adverse effects were limited in the transarterial group, the regimen of continuous transarterial infusion chemotherapy can be used more extensively in clinical practice. A CT and MRI conventional sequence can be used for efficacy evaluation after chemotherapy in pancreatic carcinoma.

Keywords

References

  1. Aigner KR, Gailhofer S, Kopp S (1998). Regional versus systemic chemotherapy for advanced pancreatic cancer: a randomized study. Hepatogastroenterology, 45, 1125-9.
  2. Fu DL, Ni QX, Yu XJ, et al (2002). Regional intra-arterial infusion chemotherapy for pancreatic cancer: an experimental study. Natl Med J Chin, 82, 371-5.
  3. Hua YP,Liang LJ,Peng BG, et al (2009). Pancreatic head carcinoma:clinical analysis of 189 cases. Hepatobiliary Pancreat Dis Int, 8, 79-84.
  4. Hwang SI,Kim Ho,Son BH, et al(2009). Surgical palliation of unresectable pancreatic head cancer in elderly patients. World J Gastroenterol, 15, 978-82. https://doi.org/10.3748/wjg.15.978
  5. Homma H, Doi T, Mezawa S, et al (2000). A novel arterial infusion chemotherapy for the treatment of patients with advanced pancreatic carcinoma after vascular supply distribution via superselective embolization. Cance, 89, 303-13. https://doi.org/10.1002/1097-0142(20000715)89:2<303::AID-CNCR15>3.0.CO;2-1
  6. Ikeda S, Maeshirok K, Ryu S, et al (2009). Diagnosis of small pancreatic cancer by endoscopic balloon-catheter spot pancreatography: an analysis of 29 patients. Pancreas, 38, 102-13. https://doi.org/10.1097/MPA.0b013e31816909ba
  7. Jia L, Yuan SZ (2002). Clinical benefit response(CBR):a new index for chemotherapy of pancreatic cancer and its application. Med Recapitulate, 8, 304-5.
  8. Klauss M, Stiller W, Fritz F, et al (2012). Computed tomography perfusion analysis of pancreatic carcinoma. J Comput Assist Tomogr, 36, 237-42. https://doi.org/10.1097/RCT.0b013e31824a099e
  9. Miller AB, Hoogstraten B, Staquet M, et al (1981).Reporting results of cancer. Treatment. Cancer, 47, 207-14. https://doi.org/10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6
  10. Moore MJ, Hamm J, Dancey J, et al (2003). Comparison of gemcitabine versus the matrix metalloproteinase inhibitor BAY 12-9566 in patients with advanced or metastatic adenocarcinoma of the pancreas: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol, 21, 3296-302. https://doi.org/10.1200/JCO.2003.02.098
  11. Ouaissi M,Sielezneff I, Pirro N, et al (2008). Pancreatic cancer and pancreaticoduodenectomy in elderly patient: morbidity and mortality are increased. Is it the real life? Hepatogastroenterology, 55, 2242-6.
  12. Shi HF, Jin ZY, Zhou ZQ, et al (2002). Transarterial infusion chemotherapy with a combination of gemcitabine and 5-fluorouracil in advanced pancreatic carcinoma. Chin J Radiol, 36, 1072-4.
  13. Tomoo K, Takahiro K, Kiyoshi M, et al (2006). A multicenter randomized controlled trial to evaluate the effect of adjuvant cisplatin and 5-fluorouracil therapy after curative resection in cases of pancreatic cancer. Jpn J Clin Oncol, 36, 159-65. https://doi.org/10.1093/jjco/hyi234
  14. Tuli R, Surmak A, Reyes J, et a l(2012). Development of a novel rreclinical pancreatic cancer research model: bioluminescence image-guided focal irradiation and tumor monitoring of orthotopic xenografts. Transl Oncol, 5, 77-84. https://doi.org/10.1593/tlo.11316
  15. Wilkowski R, Thoma M, Bruns C, et al (2006). Chemoradiotherapy with Gemcitabine and continuous 5-Fu in patients with primary inoperable pancreatic cancer. J Pancreas,7(4),349-360.
  16. Zhou J, Song SD, Li DC, et al (2012). Clinical significance of expression and amplification of the DcR3 gene in pancreatic carcinoma. Aaian Pac J Cancer Prev, 13, 719-24. https://doi.org/10.7314/APJCP.2012.13.2.719

Cited by

  1. Babaodan Capsule (八宝丹胶囊) combined with Qingyi Huaji Formula (清胰化积方) in advanced pancreatic cancer—a feasibility study pp.1993-0402, 2017, https://doi.org/10.1007/s11655-017-2279-1
  2. The combination of curcumin and 5-fluorouracil in cancer therapy vol.41, pp.1, 2018, https://doi.org/10.1007/s12272-017-0979-x