A novel interventional radiology technique for arterial infusion chemotherapy against advanced pancreatic cancer.
OBJECTIVE
Arterial infusion chemotherapy for unresectable pancreatic cancer may be an attractive strategy. We are currently developing a new interventional radiology technique to unify the pancreatic blood supply for chemoinfusion. In this article, we evaluated the feasibility, therapeutic potential, and limitations of this technique.


METHODS
Twenty-eight patients with advanced pancreatic cancer were retrospectively reviewed. After the superior mesenteric artery was embolized, the drug distribution to the tumor was evaluated by a unified CT angiography system.


RESULTS
In all patients, tumors had dual arterial blood supplies from both the celiac and superior mesenteric arteries. Unification of pancreatic blood supply was successful in 14 patients (50%). The whole pancreatic tumor was exclusively supplied by the celiac artery in these patients. In the remaining 14 patients, a part of the tumor was still supplied by the superior mesenteric artery even after embolization. In most failed cases, the tumor had invaded to the root of the small-bowel mesentery or transverse mesocolon. By contrast, unification of the pancreatic blood supply could be achieved in cases invading to the stomach and duodenum. The whole liver was also successfully supplied by arterial infusion from the celiac artery after embolization.


CONCLUSIONS
Our novel technique for arterial infusion chemotherapy is simple, feasible, and well tolerated. Furthermore, arterial chemoinfusion may be a breakthrough in selected patients with unresectable pancreatic cancer.
Tanaka
Toshihiro
T
Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan. toshihir@bf6.so-net.ne.jp
Sakaguchi
Hiroshi
H
Sho
Masayuki
M
Yamamoto
Kiyosei
K
Nishiofuku
Hideyuki
H
Nakajima
Yoshiyuki
Y
Kichikawa
Kimihiko
K
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000098:blood supply* / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents