Selective transarterial infusion chemotherapy for advanced pancreatic cancer

晚期胰腺癌的选择性经动脉灌注化疗

• 批准号: 11670901
• 负责人: MATSUMOTO Shunro
• 金额: $ 2.11万
• 依托单位: OITA MEDICAL UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11670901/
• 关键词: Pancreatic cancer; Transarterial infusion chemotherapy; Helical CT; Angiography; 化学療法

Twenty-two patients with unresectable advanced pancreatic cancer were treated by selective transarterial infusion chemotherapy during this research period. Regarding the technique of the transarterial infusion chemotherapy, 11 patients were treated by subselective injection from peripancreatic arteries (subselective injection group) and others were treated by selective injection (selective injection group). Retention of anti-cancer drug was assessed by CT immediately after the procedure. Effect of this treatment was evaluated by CT at 1 month and 3 months after the procedure. Dense retention of the anti-cancer drug in areas over 30 % of the tumor was observed in 9 patients. CT obtained at one month follow-up showed low density area corresponding to necrosis in 13 patients. These necrotic areas, which were frequently observed in subselective injection group, were significantly correlated with the areas with dense retention of anti-cancer drugs. Overall median survival period was 7 months and 1-year survival rate was 21.9 %. Nine patients in whom dense contrast retention was observed immediately after the procedure, showed better prognosis : 9.9 months for median survival period and 42 % for 1-year survival rate. The presence of peritoneal dissemination on CT before the treatment of transarterial infusion chemotherapy also affected the prognosis significantly. No other factors, including liver metastasis or lymph nodes metastasis were statistically correlated with the survival period. Although further study including larger number of patients is needed, subselective transarterial infusion chemotherapy for advanced pancreatic cancer can lead the tumor necrosis and prolonged survival in selected patients.

在本研究期间，22 名无法切除的晚期胰腺癌患者接受了选择性经动脉灌注化疗。经动脉灌注化疗技术中，11例患者采用胰周动脉亚选择性注射（亚选择性注射组），其余患者采用选择性注射（选择性注射组）。手术后立即通过 CT 评估抗癌药物的保留情况。术后1个月和3个月通过CT评估该治疗的效果。在 9 名患者中观察到抗癌药物在超过 30% 的肿瘤区域密集保留。 1个月随访时获得的CT显示13名患者对应于坏死的低密度区域。这些坏死区域在亚选择性注射组中经常观察到，与抗癌药物密集保留的区域显着相关。总体中位生存期为 7 个月，1 年生存率为 21.9%。手术后立即观察到浓密对比剂保留的 9 名患者显示出更好的预后：中位生存期为 9.9 个月，1 年生存率为 42%。经动脉灌注化疗前CT显示腹膜播散也显着影响预后。其他因素，包括肝转移或淋巴结转移，与生存期没有统计学相关。尽管需要包括更多患者的进一步研究，但针对晚期胰腺癌的亚选择性经动脉灌注化疗可以导致选定患者的肿瘤坏死并延长生存期。