title: Is it relevant that intra-arterial chemotherapy may be effective for advanced pancreatic cancer?
abstract: Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic. Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However, the response rates have been highly variable, and are often irreproducible. To improve this low response rate, various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug, generating higher local drug concentrations in tumor cells with lower toxicity. Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and, simultaneously, a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.
authors: Department of Gastroenterology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp
authors: Toru
authors: T
authors: Ishikawa
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000188:drug therapy*; D012039:Regional Blood Flow / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents
references: Br J Surg. 1994 Jan;81(1):102-7
references: 7906180
references: Ann Surg. 1987 Sep;206(3):366-73
references: 2820322
references: Ann Oncol. 1995 Oct;6(8):801-4
references: 8589018
references: Lancet Oncol. 2005 Sep;6(9):644
references: 16161265
references: Gan To Kagaku Ryoho. 2004 Oct;31(10):1555-8
references: 15508450
references: Ann Oncol. 2000 May;11(5):569-73
references: 10907950
references: Am J Surg. 1991 Jan;161(1):120-4; discussion 124-5
references: 1987845
references: Gan To Kagaku Ryoho. 2003 Aug;30(8):1151-5
references: 12938272
references: Hepatogastroenterology. 2007 Dec;54(80):2378-82
references: 18265669
references: Biorheology. 1984;21(4):503-8
references: 6487762
references: Cancer. 1981 Mar 15;47(6 Suppl):1724-8
references: 6456058
references: J Natl Cancer Inst. 1989 Jan 18;81(2):116-24
references: 2562856
references: In Vivo. 2006 Nov-Dec;20(6A):751-5
references: 17203761
references: Pancreatology. 2003;3(5):367-73; discussion 373-4
references: 14526145
references: Cancer. 1996 Aug 1;78(3 Suppl):633-8
references: 8681302
references: Eur J Cancer. 1996 Jun;32A(6):1039-50
references: 8763346
references: Am J Clin Oncol. 1982 Oct;5(5):555-8
references: 6217742
references: Gan To Kagaku Ryoho. 2001 Aug;28(8):1137-40
references: 11525032
references: Gan To Kagaku Ryoho. 2001 Apr;28(4):521-5
references: 11329788
references: Eur J Cancer. 1978 Jul;14(7):761-4
references: 658101
references: Hepatogastroenterology. 1993 Oct;40(5):433-42
references: 8270232
references: Int J Pancreatol. 1998 Jun;23 (3):181-6
references: 9629517
references: Am J Surg. 1994 Oct;168(4):361-4
references: 7943597
references: Gan To Kagaku Ryoho. 2005 Apr;32(4):523-7
references: 15853221
references: Hepatogastroenterology. 1998 May-Jun;45(21):644-50
references: 9684110
references: Cancer. 1996 Aug 1;78(3 Suppl):664-73
references: 8681305
references: N Engl J Med. 1993 May 20;328(20):1485-6
references: 8479469
references: Cancer Treat Rev. 1975 Sep;2(3):193-214
references: 1104163
references: Hepatogastroenterology. 1998 May-Jun;45(21):638-43
references: 9684109
references: Gan To Kagaku Ryoho. 2005 Apr;32(4):469-72
references: 15853212
references: J Hepatobiliary Pancreat Surg. 2002;9(1):61-75
references: 12021899
references: Cancer. 1985 Jan 15;55(2):311-6
references: 2981143
references: Cancer. 1981 Jan 1;47(1):207-14
references: 7459811
references: Med Klin (Munich). 1995 Sep 15;90(9):501-5
references: 7476726
references: World J Gastroenterol. 2007 Jun 14;13(22):3080-3
references: 17589923
references: Clin Exp Metastasis. 1997 Sep;15(5):484-98
references: 9247251
references: World J Surg. 1999 Sep;23(9):946-9
references: 10449825
references: Cancer. 2000 Jul 15;89(2):303-13
references: 10918160
references: J Clin Oncol. 1992 Jul;10(7):1112-8
references: 1296590
references: Br J Cancer. 1996 May;73(10):1260-4
references: 8630289
references: J Clin Oncol. 1997 Jun;15(6):2403-13
references: 9196156
references: Hematol Oncol Clin North Am. 2002 Feb;16(1):199-215
references: 12063827
references: Ann Oncol. 1996 Apr;7(4):347-53
references: 8805925