Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System

被引:7
作者
Hashimoto, Aya [1 ,2 ]
Tanaka, Toshihiro [1 ]
Sho, Masayuki [3 ]
Nishiofuku, Hideyuki [1 ]
Masada, Tetsuya [1 ]
Sato, Takeshi [1 ]
Marugami, Nagaaki [1 ]
Anai, Hiroshi [2 ]
Sakaguchi, Hiroshi [4 ]
Kanno, Masatoshi [5 ]
Tamamoto, Tetsuro [6 ]
Hasegawa, Masatoshi [6 ]
Nakajima, Yoshiyuki [3 ]
Kichikawa, Kimihiko [1 ]
机构
[1] Nara Med Univ, Dept Radiol, 840 Shijo Cho, Kashihara, Nara 6348522, Japan
[2] Nara City Hosp, Dept Radiol, Nara, Japan
[3] Nara Med Univ, Dept Surg, Kashihara, Nara 6348522, Japan
[4] Nara Prefectural Western Med Ctr, Dept Radiol, Sango, Japan
[5] Nara Med Univ, Ctr Oncol, Kashihara, Nara 6348522, Japan
[6] Nara Med Univ, Dept Radiat Oncol, Kashihara, Nara 6348522, Japan
关键词
Arterial infusion chemotherapy; Pancreatic cancer; Liver metastases; LIVER PERFUSION CHEMOTHERAPY; CURATIVE RESECTION; DUCTAL ADENOCARCINOMA; GEMCITABINE; SURGERY; RECURRENCE; PLACEMENT; FEASIBILITY; METASTASIS; CARCINOMA;
D O I
10.1007/s00270-016-1292-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose Previous reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer. Materials and Methods 93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used. Results The overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312). Conclusions The coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.
引用
收藏
页码:831 / 839
页数:9
相关论文
共 33 条
[1]   Intermittent hepatic arterial infusion of high-dose 5FU on a weekly schedule for liver metastases from colorectal cancer [J].
Arai, Y ;
Inaba, Y ;
Takeuchi, Y ;
Ariyoshi, Y .
CANCER CHEMOTHERAPY AND PHARMACOLOGY, 1997, 40 (06) :526-530
[2]   Percutaneous Catheter Placement for Hepatic Arterial Infusion Chemotherapy [J].
Arai, Yasuaki ;
Takeuchi, Yoshito ;
Inaba, Yoshitaka ;
Yamaura, Hidekazu ;
Sato, Yozo ;
Aramaki, Takeshi ;
Matsueda, Kiyoshi ;
Seki, Hiroshi .
TECHNIQUES IN VASCULAR AND INTERVENTIONAL RADIOLOGY, 2007, 10 (01) :30-37
[3]  
Barugola G, 2007, J PANCREAS, V8, P132
[4]   Intraarterial adjuvant chemotherapy after pancreaticoduodenectomy for pancreatic cancer:: Significant reduction in occurrence of liver metastasis [J].
Beger, HG ;
Gansauge, F ;
Büchler, MW ;
Link, KH .
WORLD JOURNAL OF SURGERY, 1999, 23 (09) :946-949
[5]   Phase II study of a fixed dose-rate infusion of gemcitabine associated with uracil/tegafur in advanced carcinoma of the pancreas [J].
Feliu, J ;
Mel, R ;
Borrega, P ;
Gómez, LL ;
Escudero, P ;
Dorta, J ;
Castro, J ;
Vázquez-Estévez, SE ;
Bolaños, M ;
Espinosa, E ;
Barón, MG .
ANNALS OF ONCOLOGY, 2002, 13 (11) :1756-1762
[6]   Pancreatic adenocarcinoma: The actual 5-year survivors [J].
Ferrone, Cristina R. ;
Brennan, Murray F. ;
Gonen, Mithat ;
Coit, Daniel G. ;
Fong, Yuman ;
Chung, Sun ;
Tang, Laura ;
Klimstra, David ;
Allen, Peter J. .
JOURNAL OF GASTROINTESTINAL SURGERY, 2008, 12 (04) :701-706
[7]  
GRIFFIN JF, 1990, CANCER, V66, P56, DOI 10.1002/1097-0142(19900701)66:1<56::AID-CNCR2820660112>3.0.CO
[8]  
2-6
[9]   Clinical utility of coaxial reservoir system for hepatic arterial infusion chemotherapy [J].
Hamada, Ayumi ;
Yamakado, Koichiro ;
Nakatsuka, Alsuhiro ;
Takaki, Haruyuki ;
Takeda, Kan .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2007, 18 (10) :1258-1263
[10]   Clinical results on intra-arterial adjuvant chemotherapy for prevention of liver metastasis following curative resection of pancreatic cancer [J].
Hayashibe, Akira ;
Kameyama, Masao ;
Shinbo, Masaya ;
Makimoto, Shinichiro .
ANNALS OF SURGICAL ONCOLOGY, 2007, 14 (01) :190-194