Regional chemotherapy with percutaneous left subclavain artery implantation of port-catheter drug delivery system for inoperable pancreatic carcinoma / 中华消化杂志

ABSTRACT

Objective To evaluate the therapeutic effect of implanted drug delivery system (DDS) in patients with inoperable pancreatic carcinoma.Methods During 1998 to 2004,145 patients with no indication for operation were randomly divided into two groups.In 73 patients with regional interventional chemotherapy group (group A),percutaneous left subclavain artery port-catheter DDS implantation with the tip in common hepatic artery was performed, and regional chemotherapy infusion were done in every 1 to 2 month. In 72 patients with systemic chemotherapy group (group B), the chemotherapy were given via peripheral vein in every 1 to 2 month. The FAM(adriamycin 40 mg/m2+mitomycin 6 mg/m2+fluorouracil 375 mg/m2) were selected in two groups. Results In group A, after 2-10 (average 7.6) cycles of chemotherapy, 4 patients reached complete release (CR) and 49 patients reached partial release (PR). In group B, after 1-7 (average 3.8) cycles of chemotherapy, no patient reached CR and 25 patients reached PR. The effective ratio was 60.2% and 34.7% in group A and B, respectively. The survival time ranged from 3 to 34 months (median 13.5 months) in group A and 1 to 13 months (median 6.2 months) in group B. Among the 56 patients with obstinate pain in group A, 27 patients were free of pain and 22 patients got partially alleviation 2-3 weeks after chemotherapy. Among the 54 patients with obstinate pain in group B, 11 patients were free of pain and 14 patients got partially alleviation 2-3 weeks after chemotherapy. The pain-releasing ratio in group A and group B was 87.5% and 46.3%. There were no severe damage of liver, kidney, heart and bone marrow in group A. Twenty five patients in group A experienced mild digestive side-effect and decrease of white blood cells, all of them completed the chemotherapy. In group B, 3 patients experienced bone marrow arrest, one died of severe damage of liver and kidney, and 67 patients displayed digestive side-effect and decrease of white blood cells. The ratio of side-effect in group B was 90.3%. The differences of effective ratio, survival time and side-effect ratio between group A and B were statistically significant (P