Advanced pancreatic carcinoma showing a complete response to arterial infusion chemotherapy.
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.
Homma
Hisato
H
Gastroenterogy Center, Tokeidai Hospital, North 1, East 1, Chuo-ku, Sapporo 060-0031, Japan. hisahomma@tokeidaihosp.or.jp
Akiyama
Takehide
T
Mezawa
Shinichi
S
Doi
Tadashi
T
Takanashi
Kunihiro
K
Machida
Takuro
T
Murakami
Ken
K
Katsuki
Shinichi
S
Sato
Tsutomu
T
Hirata
Kenichiro
K
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
D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine