title: Intra-arterial chemoinfusion prior to chemoradiotherapy with full-dose systemic gemcitabine for management of locally advanced pancreatic cancer.
abstract: BACKGROUND
  Although chemoradiotherapy with full-dose gemcitabine as a strategy for locally advanced pancreatic cancer was expected to optimize local tumor control and prevent distant metastasis, the volume of the radiation field is the critical factor related to toxicities. We are currently developing a novel therapeutic technique to conduct neoadjuvant treatments of intra-arterial chemoinfusion prior to chemoradiotherapy with the aim of tumor volume reduction.
  
  
  METHODS
  In two patients with locally invasive pancreatic cancer, the pancreatic blood supply was altered under angiographic guidance, and an intra-arterial catheter with a subcutaneous port was left in place for the administration of 5-fluorouracil (5-FU) 1,000 mg/m(2). After shrinkage of the tumor, chemoradiotherapy with gemcitabine 1,000 mg/m(2) was delivered. In both patients, the full-dose gemcitabine was administered concurrently with radiation therapy without severe complications. The patients responded to the treatment with survival times of 42 and 38 months.
  
  
  CONCLUSIONS
  Intra-arterial chemoinfusion followed by chemoradiation with full-dose systemic gemcitabine might prove to be a promising therapeutic approach for locally advanced pancreatic cancer. Large prospective Phase II trials of this combination regimen are warranted.
authors: Department of Radiology, Nara Medical University, 840 Shijo-cho Kashihara, 634-8522, Japan. toshihir@bf6.so-net.ne.jp
authors: Toshihiro
authors: T
authors: Tanaka
authors: Hideyuki
authors: H
authors: Nishiofuku
authors: Tetsuro
authors: T
authors: Tamamoto
authors: Masayuki
authors: M
authors: Sho
authors: Hiroshi
authors: H
authors: Anai
authors: Satoru
authors: S
authors: Sueyoshi
authors: Hiroshi
authors: H
authors: Sakaguchi
authors: Masatoshi
authors: M
authors: Hasegawa
authors: Yoshiyuki
authors: Y
authors: Nakajima
authors: Kimihiko
authors: K
authors: Kichikawa
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000628:therapy*; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine