title: Portal vein infusion chemotherapy with gemcitabine after surgery for pancreatic cancer.
abstract: OBJECTIVE
  Pancreatic cancer still has a poor prognosis even after curative resection because of the high incidence of postoperative liver metastasis. This study prospectively evaluated the feasibility and tolerability of portal vein infusion chemotherapy of gemcitabine (PVIG) as an adjuvant setting after pancreatic resection.
  
  
  METHODS
  Thirteen patients enrolled in this study received postoperative chemotherapy with PVIG. The patients received intermittent administration of gemcitabine (800 mg/m(2)) via the portal vein on days 1, 8, and 15 after surgery. The tolerability and the toxicity of PVIG were closely monitored.
  
  
  RESULTS
  The PVIG was started on an average of 3.1 days after surgery. Complete doses of chemotherapy (three sessions of portal infusion) were accomplished in 11 of the 13 patients. Grade 3 or 4 leukocytopenia was observed in three patients (23 %), and liver dysfunction was found in one patient (7.7 %). Grade 2 sepsis developed in two cases due to bloodstream infection. Liver metastasis was the first site of recurrence in only two patients.
  
  
  CONCLUSIONS
  PVIG can be administered to the liver with acceptable toxicity, but myelosuppression is similar to the systemic use of gemcitabine. Careful observation is required even for locoregional chemotherapy.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan.
authors.forename: Chi-E
authors.initials: CE
authors.lastname: Kitami
authors.forename: Isao
authors.initials: I
authors.lastname: Kurosaki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kawachi
authors.forename: Koei
authors.initials: K
authors.lastname: Nihei
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tsuchiya
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nomura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Minagawa
authors.forename: Kabuto
authors.initials: K
authors.lastname: Takano
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044584:Carcinoma, Ductal / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000628:therapy*; D011169:Portal Vein; D011446:Prospective Studies; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000093542:Gemcitabine