Regional chemotherapy for pancreatic cancer.

摘要

In 2010, there were an estimated 43,140 new cases and 36,800 deaths attributed to pancreatic cancer (PC) in the United States [1]. Overall survival is poor. Approximately, 23% of patients living 12 months after diagnosis, and 5-year survival is <5% [2]. Survival past 5 years is possible for patients that undergo complete resection and approximates a median of 20 months [3]. However, <20% of patients with PC present with resectable tumors. Since resection offers the only chance at cure, several investigators hypothesized that increasing resectability rate might result in survival benefit.Since the 1950s, regional administration of chemotherapy has been evaluated and proven an effective therapy for various locoregional diseases. The use of regional chemotherapy has been reported in 21 studies encompassing 895 pancreatic cancer patients. All patients were in either stage III (locally advanced) or IV. Regional chemotherapy techniques used were arterial infusion and perfusion with or without hemofiltration, celiac axis infusion (CAI; 57.1%), selective arterial infusion (SAI; 23.8%), and hypoxic stop-flow abdominal perfusion (HAP: 28.6%). Some studies used several techniques sequentially.