Selective transarterial infusion chemotherapy for advanced pancreatic cancer

在本研究期间，22例不能切除的晚期胰腺癌患者接受了选择性动脉灌注化疗。经胰周动脉灌注化疗的方法：11例采用胰周动脉亚选择性灌注化疗（亚选择性灌注组），11例采用胰周动脉选择性灌注化疗（选择性灌注组）。术后立即通过CT评估抗癌药物的保留。术后1个月、3个月行CT检查，评价疗效。在9名患者中观察到抗癌药物在超过30%的肿瘤区域中的密集保留。随访1个月CT显示13例患者出现低密度坏死区。这些坏死区域在亚选择性注射组中常见，与抗癌药物密集滞留区域显著相关。总的中位生存期为7个月，1年生存率为21.9%。术后立即观察到密集造影剂滞留的9例患者显示出较好的预后：中位生存期为9.9个月，1年生存率为42%。动脉灌注化疗前CT显示腹膜播散对预后也有显著影响。肝转移、淋巴结转移与生存期无相关性。虽然需要更多的患者进行进一步的研究，但晚期胰腺癌的亚选择性动脉灌注化疗可导致肿瘤坏死，并延长部分患者的生存期。

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.