Liver Perfusion Chemotherapy With 5-Fluorouracil Followed by Systemic Gemcitabine Administration for Resected Pancreatic Cancer
| Autor: | Naoyuki Yokoyama, Isao Kurosaki, Takeaki Shimizu, Koei Nihei, Yasuyuki Kawachi, Yoshiaki Tsuchiya, Takashi Aono, Katsuyoshi Hatakeyama |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Oncology medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Phases of clinical research Deoxycytidine Gastroenterology Endocrinology Internal medicine Pancreatic cancer Antineoplastic Combined Chemotherapy Protocols Internal Medicine medicine Humans Prospective Studies Survival rate Chemotherapy Hepatology business.industry Liver Neoplasms Cancer Middle Aged medicine.disease Gemcitabine Portal vein thrombosis Pancreatic Neoplasms Survival Rate Fluorouracil Chemotherapy Cancer Regional Perfusion Lymphatic Metastasis Female Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | Pancreas. 38:161-167 |
| ISSN: | 0885-3177 |
| DOI: | 10.1097/mpa.0b013e31818815f7 |
| Popis: | Objectives Liver perfusion chemotherapy (LPC) for pancreatic cancer has been rarely undertaken in a postoperative adjuvant setting. We evaluated the feasibility and antitumor efficacy of LPC with 5-fluorouracil (5-FU) followed by gemcitabine treatment. Methods This prospective study enrolled 27 patients who underwent pancreatic resection and subsequent LPC + gemcitabine treatment during a 3-year period. The liver was infused with 5-FU (125 mg/body per day per route) via both routes of hepatic artery and portal vein for more than 21 days. After that, gemcitabine (1000 mg/m) was administered biweekly. Results Portal vein thrombosis developed in 1 patient, but 89% patients tolerated LPC for more than 21 days with no life-threatening complication. Systemic administration of gemcitabine was accomplished in 93%; however, 1 patient died of serious capillary leak syndrome. No grade 4 toxicity was recorded, except for that patient. Median survival time and disease-free survival were 27.5 and 24.5 months, respectively. Hepatic relapse was observed in 25.9% (n = 7). Survival was in favor of paraaortic node-negative cases (n = 20) with a 2-year survival of 68.7%. Conclusions Liver perfusion chemotherapy was feasible with acceptable toxicity. Systemic use of gemcitabine also seems to be safe for the most part. This adjuvant chemotherapy shows promising survival benefit and seems to be indicative to paraaortic node-negative tumors. |
| Databáze: | OpenAIRE |
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