[Chemotherapy for adenocarcinoma of the pancreas]

The present article reviews previous reports on the systemic and regional chemotherapies for adenocarcinoma of the pancreas. When non-resectable pancreatic cancer was treated by the systemic chemotherapy, most reports showed that the mean or median survival periods were less than 6 months. Although the response rate to multi-drug chemotherapy was superior than that to single-drug chemotherapy, the survival period did net differ significantly between the two. In general, in terms of the patients, survival rates, the combination og chemo-therapy and radiation was slightly superior to either chemotherapy or radiation alone. On the other hand, regional chemotherapy seems to be more promising because our intra-arterial chemotherapy using angiontensin-II has succeeded in improving the mean survival period to 14 months for non-resectable pancreatic cancer. Likewise, liver perfusion chemotherapy via the hepatic artery and portal vein was effective in preventing the development of liver metastasis after pancreatectomy. Considering that the pancreatic cancer is a poorly vascularized tumor, it is essential to deliver a high dose of anti-cancer drug effectively into the cancer tissue. Secondarily, the selection of drug to which the pancreatic cancer cell is sensitive is also important.