Advanced pancreatic carcinoma showing a complete response to arterial infusion chemotherapy

Homma, Hisato; Akiyama, Takehide; Mezawa, Shinichi; Doi, Tadashi; Takanashi, Kunihiro; Machida, Takuro; Murakami, Ken; Katsuki, Shinichi; Sato, Tsutomu; Hirata, Ken‐ichi

doi:10.1007/s10147-004-0388-2

Cited by 8 publications

(2 citation statements)

References 6 publications

(6 reference statements)

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“…Non‐resectable advanced pancreatic carcinoma tends to poorly respond to medical treatment, with a median survival time of 6 months or less for patients with stage IV disease. Splenic‐artery embolization has been used to selectively infuse antitumor agents into the pancreatic parenchyma 75–77 …”

Section: Resultsmentioning

confidence: 99%

Partial splenic embolization

Yoshida

Mamada

Taniai

et al. 2007

Hepatology Research

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Partial splenic embolization (PSE) is a non-surgical procedure developed to treat hypersplenism as a result of hepatic disease and thus avoid the disadvantages of splenectomy. A femoral artery approach is used for selective catheterization of the splenic artery. Generally, the catheter tip is placed as distally as possible in an intrasplenic artery. After an injection of antibiotics and steroids, embolization is achieved by injecting 2-mm gelatin sponge cubes suspended in a saline solution containing antibiotics. PSE can benefit patients with thrombocytopenia, esophagogastric varices, portal hypertensive gastropathy, encephalopathy, liver dysfunction, splenic aneurysm, and splenic trauma. The contraindications of PSE include secondary splenomegaly and hypersplenism in patients with terminal-stage underlying disease; pyrexia or severe infections are associated with a high risk of splenic abscess after PSE. Complications of PSE include daily intermittent fever, abdominal pain, nausea and vomiting, abdominal fullness, appetite loss, and postembolization syndrome. Decreased portal-vein flow and a rapid increase in the platelet count after excessive embolization may cause portal-vein or splenic-vein thrombosis.

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Section: Resultsmentioning

confidence: 99%

Partial splenic embolization

Yoshida

Mamada

Taniai

et al. 2007

Hepatology Research

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“…Arterial infusion chemotherapy with GEM and 5-FU has been reported as a treatment for locally advanced pancreatic cancer and liver metastases from pancreatic cancer (10,21,22). Furthermore, in previous phase I studies, HAI chemotherapy with GEM was well-tolerated up to 1,000 mg/m 2 infused over 400 min (8,9).…”

Section: Discussionmentioning

confidence: 99%

Hepatic arterial infusion chemotherapy with gemcitabine and 5-fluorouracil or oral S-1 improves the prognosis of patients with postoperative liver metastases from pancreatic cancer

Tajima

Kitagawa

Tsukada

et al. 2013

Molecular and Clinical Oncology

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Hepatic metastasis is a common cause of treatment failure following resection of pancreatic cancer. In this study, we report our results of hepatic arterial infusion (HAI) chemotherapy with gemcitabine (GEM) plus 5-fluorouracil (5-FU) or oral S-1 treatment for postoperative liver metastases from pancreatic cancer. Seven patients with postoperative liver metastases from pancreatic cancer received HAI with GEM plus 5-FU or oral S-1 between October, 2008 and September, 2010 at Kanazawa University Hospital (Kanazawa, Japan). Three out of the 7 cases exhibited a partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) and stable disease (SD) was achieved in 3 out of the 7 cases (response rate, 85.7%). A decrease in serum tumor marker CA 19-9 levels was observed after 10 HAI treatment cycles in 5 out of the 7 cases. The median time to treatment failure was 8 months (range, 0–17 months). Adverse events included grade 3 leukocytopenia in 1 case and anemia in all 7 cases, although 5 out of the 7 patients were anemic prior to HAI therapy. Grade 2 thrombocytopenia was also observed in 2 cases. Non-hematological events, such as nausea, diarrhea, liver injury or neuropathy and life-threatening toxicities were not reported; however, 6 patients (85.7%) developed catheter-related complications and the HAI catheter and subcutaneous implantable port system had to be removed. These findings demonstrated that HAI may deliver high doses of chemotherapeutic agents directly into the tumor vessels, producing increased regional levels with greater efficacy and a lower incidence/severity of systemic side effects. In conclusion, HAI chemotherapy is a safe and effective treatment for liver metastases from pancreatic cancer.

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