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Celiac axis infusion chemotherapy in advanced nonresectable pancreatic cancer

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Summary

Conclusion

Based on these data we suggest that regional intra-arterial chemotherapy for advanced pancreatic cancer seems not to be superior to common treatment modalities, such as combined radiochemotherapy.

Background

The prognosis for advanced pancreatic cancer is very poor. No standard treatment is available. Recently, better survival and quality of life was reported from regional cancer treatment via celiac axis infusion. In an attempt to confirm these results we conducted a phase II study of intra-arterial chemotherapy for nonresectable pancreatic cancer.

Methods

From May 1994 to February 1995, 12 consecutive patients with biopsy-proven advanced ductal carcinoma of the exocrine pancreas were given intra-arterial infusions consisting of Mitoxantrone, 5-FU+ folinic acid, and Cisplatin via a transfemorally placed catheter in the celiac axis. Six patients were classified as UICC stage III and six as stage IV with the liver as the sole site of distant metastasis. Nine patients had primary and three had recurrent pancreatic carcinoma after a Whipple procedure. Nonresectability of primary tumors was assessed in all patients by laparotomy or laparoscopy.

Results

A total of 31 cycles of chemotherapy (mean 2.6 cycles/patient) was administered. Catheter placement was technically feasible in all cycles. A groin hematoma was the only catheter complication. The follow-up by CT sans at 2-mo intervals revealed partial remission in 1 patient (8%), temporary stable disease in 4 patients (33%), and disease progression in 7 patients (58%). The same response was obtained after analyzing the CA 19-9 course. Median survival in stage III patients was 8.5 mo (3–12 mo) and in stage IV patients 5 mo (2–11 mo). Toxicity according to WHO criteria consisted of grade III (4 events), grade II (10 events), and grade I (17 events), mainly resulting from leucopenia and diarrhea/vomiting. Nine of 11 patients experienced temporary relief of pain immediately after regional treatment.

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Authors and Affiliations

  1. Institute of Visceral and Transplantation Surgery, University of Bern, Switzerland

    Christoph A. Maurer, Jörg Läuffer, Helmut Friess, Kaspar Z'graggen & Markus W. Büchler (Head of the Department of Visceral and Transplantation Surgery)

  2. Institute of Medical Oncology, University of Bern, Switzerland

    Markus M. Borner

  3. Institute of Radiology, University of Bern, Switzerland

    Jürgen Triller

Authors
  1. Christoph A. Maurer
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  2. Markus M. Borner
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  3. Jörg Läuffer
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  4. Helmut Friess
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  5. Kaspar Z'graggen
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  6. Jürgen Triller
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  7. Markus W. Büchler
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Maurer, C.A., Borner, M.M., Läuffer, J. et al. Celiac axis infusion chemotherapy in advanced nonresectable pancreatic cancer. Int J Pancreatol 23, 181–186 (1998). https://doi.org/10.1007/BF02788395

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  • DOI: https://doi.org/10.1007/BF02788395

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