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.

CONCLUSION:

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.