title: Advanced pancreatic carcinoma showing a complete response to arterial infusion chemotherapy.
abstract: We report a patient with advanced carcinoma of the pancreatic body and tail with multiple liver metastases who showed a complete response to hepatic and splenic arterial infusion chemotherapy (HSAIC) with gemcitabine and 5-fluorouracil, following transcatheter peripancreatic arterial embolization (TPPAE) and partial splenic embolization (PSE). Nonresectable advanced pancreatic carcinoma tends to have a low response to medical treatment, with the median survival time being 6 months or less for stage IV cases. We disclose herein that the median survival time of patients receiving HSAIC after TPPAE is more than three times longer than the survival time attained with conventional treatments. However, in patients with advanced carcinoma of the pancreatic tail, for which TTPAE is not applicable, survival times remain low. Thus, in the patient described here, we also performed embolization of the left gastric and short gastric arteries as well as PSE to increase the flow within the great pancreatic and caudal pancreatic arteries via the splenic artery, and gemcitabine and 5-fluorouracil were administered via the splenic artery. As a result of these procedures, marked reduction in the advanced carcinoma of the pancreatic body and tail and of liver metastases was attained.
authors.affiliation: Gastroenterogy Center, Tokeidai Hospital, North 1, East 1, Chuo-ku, Sapporo 060-0031, Japan. hisahomma@tokeidaihosp.or.jp
authors.forename: Hisato
authors.initials: H
authors.lastname: Homma
authors.forename: Takehide
authors.initials: T
authors.lastname: Akiyama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Mezawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Doi
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Takanashi
authors.forename: Takuro
authors.initials: T
authors.lastname: Machida
authors.forename: Ken
authors.initials: K
authors.lastname: Murakami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Katsuki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sato
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply / Q000556:secondary; D008297:Male; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine