Liver metastasis of pancreatic cancer managed by intra-arterial infusion chemotherapy combined with degradable starch microspheres.
A patient with liver metastasis of pancreatic cancer received chemotherapy using mitomycin C and degradable starch microspheres. The patient was a 52-year-old woman who had undergone surgery for cancer of the head of the pancreas in October 1996. She had stage III disease and was followed up as an outpatient on oral therapy with a combined uracil and tegafur preparation. In October 2000, abdominal computed tomography (CT) scans detected multiple liver metastases. Three courses of intra-arterial infusion of mitomycin C and microspheres (1000 mg) resulted in regression of her tumor and a decrease of tumor marker levels. After three more courses of this therapy, the patient developed bile duct necrosis and died of disseminated intravascular coagulation. As her metastases were controlled for about 7 months, hepatic arterial infusion of mitomycin C and degradable starch microspheres appears to be useful for treating liver metastasis of pancreatic cancer, but careful attention should be paid to the risk of severe complications such as bile duct necrosis.
Department of Gastroenterological Surgery, Hachiohji Medical Center, Tokyo, Japan.
Kenji
K
Katsumata
Hidenori
H
Tomioka
Tetsuo
T
Sumi
Tatsuyuki
T
Yamasaki
Makoto
M
Takagi
Fumiharu
F
Kato
Yoshiaki
Y
Suzuki
Tatsuya
T
Aoki
Yasuhisa
Y
Koyanagi
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001649:Bile Duct Diseases / Q000139:chemically induced*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects; D009336:Necrosis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000628:therapy; D016577:Pancreaticoduodenectomy / Q000379:methods; D018570:Risk Assessment; D013213:Starch / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
C083286:degradable starch microspheres; D016685:Mitomycin; D004317:Doxorubicin; D013213:Starch; C027260:pirarubicin