Phase II trials of pancreatic and hepatic arterial infusion of 5-fluorouracil (5-FU) and cisplatin (CDDP) in patients with advanced pancreatic cancer with or without liver metastasis

Abstract

4140 Background: Liver metastasis is a common progression of pancreatic cancer. The purpose of this study was to examine the efficacy and safety of a modality therapy consisting of pancreatic and hepatic arterial infusion of 5-FU and CDDP in patients with advanced pancreatic cancer with or without liver metastasis. Methods: 12 patients with unresectable pancreatic cancer were enrolled in this study. 8 patients had locally advanced pancreatic cancer with no distant metastases (Group A). 4 patients had advanced pancreatic cancer with no distant metastases except to the liver (Group B). To restrict the blood flow into the pancreas and the liver, the peripancreatic artery (ex. dorsal pancreatic artery) were embolized superselectively with microcoils. The tip of the catheter was placed in the proper hepatic artery and the side hole was placed in the gastroduodenal artery for the patients of pancreas head cancer. The splenic artery and the common hepatic artery were used for the patients of pancreas body or tail cancer. The patients of Group A received both hepatic and pancreatic arterial injection chemotherapy to prevent liver metastasis. The arterial infusion chemotherapy consisted of 5-FU 250 mg/sqm administration as a 24-hr continuous arterial infusion and a bolus injection of CDDP 5mg/sqm three times a week for two weeks to all 12 patients. Consequently, 8 of 12 patients were administered 5-FU 600mg/sqm as a 5-hr continuous arterial infusion weekly. Results: 3 patients of Group A had PR (Overall response was 37.5%). None of Group B had CR or PR. Median survival time was 16.3 months for Group A and 6.1 months for Group B. One of Group A had liver metastasis after this treatment. Toxicity was predictable and in general manageable. One patient had the grade 4 hematotologic toxicity but recovered. Conclusions: In patients with unresectable pancreatic cancer, hepatic and pancreatic arterial injection chemotherapy after hemodynamic change is effective to treat main pancreatic tumor and to prevent liver metastasis. No significant financial relationships to disclose.