title: Intra-arterial infusion chemotherapy with 5-fluorouracil and cisplatin in advanced pancreatic cancer: a feasibility study.
abstract: OBJECTIVE
  Our aim was to examine the efficacy and tolerability of intra-arterial infusion chemotherapy with 5-fluorouracil (5-FU) and cisplatin in advanced pancreatic cancer.
  
  
  METHODS
  Sixteen patients with unresectable locally advanced or metastatic pancreatic cancer (12 Stage IVa and 4 Stage IVb with liver metastasis) were enrolled. The catheter for intra-arterial infusion was placed at the position to distribute chemotherapeutic drugs to both the pancreatic tumor and the liver. Continuous infusion of 5-FU (250 mg/m(2) per day, 7 days) with intermittent bolus injection of cisplatin (5 mg/m(2) per day, 5 days) was repeated twice via the catheter, followed by intermittent injection of 5-FU (375 or 750 mg/m(2)) or cisplatin (7.5 mg/m(2)) once a week. The survival of these patients was compared with that of the matched historical control patients treated with other modalities.
  
  
  RESULTS
  In 12 Stage IVa locally advanced patients, the response rate was 58.3% (7 partial response). The median survival time was 22.0 months, and the 1-, 2-, and 3-year survival rates were 83.3%, 41.7%, and 16.7%, respectively. The locally advanced patients treated with intra-arterial infusion chemotherapy showed significantly better survival than the control patients. In contrast, Stage IVb patients with liver metastasis showed no response to the treatment (response rate, 0%). Treatment was discontinued in 2 patients until recovery from hematologic or hepatic toxicity, but fatal adverse events were not observed.
  
  
  CONCLUSIONS
  These results suggest that intra-arterial infusion chemotherapy with 5-FU and cisplatin is tolerable and feasible treatment to improve the prognosis in locally advanced pancreatic cancer patients without distant metastasis.
authors: Department of Surgery, Kitano Hospital, Tazuke-Kofukai Medical Research Institute, Osaka, Japan. tsasada@kitano-hp.or.jp
authors: Tetsuro
authors: T
authors: Sasada
authors: Ryusuke
authors: R
authors: Denno
authors: Tomoharu
authors: T
authors: Tanaka
authors: Michiyuki
authors: M
authors: Kanai
authors: Yo
authors: Y
authors: Mizukami
authors: Shigene
authors: S
authors: Kohno
authors: Arimichi
authors: A
authors: Takabayashi
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil