[Adjuvant arterial infusion chemotherapy for patients with pancreatic cancer]

Although surgery is the only potentially curative treatment for pancreatic cancer, patients undergoing complete resection frequently develop liver metastasis, local recurrence, and peritoneal metastasis. Liver metastasis is a common mode for the progression of pancreatic cancer, and the prognosis of patients in whom it occurs is extremely poor. Between January 2000 and December 2002, 10 patients received adjuvant arterial infusion chemotherapy after resection of pancreatic cancer. Eight of these 10 patients underwent pancreaticoduodenectomy and 2 had distal pancreatectomy. Catheters were placed using Seldinger's technique, with the tip being advanced into the common hepatic artery via the femoral artery. Then, 1,000 mg/body of 5-FU was administered by 24-hour continuous infusion for 6 days per week (days 1-3 and 5-7). Two cycles of chemotherapy were delivered through an angiographic catheter without a reservoir port. During this treatment, no severe systemic or abdominal complications were observed. The 2 groups were well balanced with respect to prognostic factors. The survival rate at 1 year was 77.8% and 41.6% for the adjuvant chemotherapy group and non-adjuvant chemotherapy group, respectively, while the 3-year survival rates were 48.6% and 20.8% (Wilcoxon test, p = 0.0649). The median overall survival rate was superior in the adjuvant chemotherapy group, although the difference was not statistically significant. High-dose 5-FU arterial infusion chemotherapy seems to be a safe, tolerable, and effective regimen for the postoperative recurrence of pancreatic cancer.