Document Detail


Intra-arterial infusion chemotherapy with angiotensin-II for locally advanced and nonresectable pancreatic adenocarcinoma: further evaluation and prognostic implications.
MedLine Citation:
PMID:  14527913     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: For locally advanced and nonresectable cancer of the pancreas, we performed intra-arterial infusion chemotherapy with angiotensin-II (AT-II). In our preliminary report, this treatment resulted in a median of 14 months of survival without objective adverse effects. This study was designed to clarify the prognostic factor in this chemotherapy by using a larger number of cases. METHODS: For 32 patients, intra-arterial chemotherapy was performed: 1 or 2 catheters were intraoperatively placed into the pancreas-supplying arteries. The tissue blood flow and its change by AT-II infusion were determined. For intra-arterial chemotherapy, a mixture of methotrexate (50 or 100 mg/m(2)) and AT-II (.4 microg/kg/hour) was repeatedly infused from the catheter, mainly at our outpatient clinic. RESULTS: With our intra-arterial chemotherapy, the median survival period was 13 months. The median survival period was 19 months in patients without coexisting pancreatitis but was only 9 months in those with it (P =.0003). The presence or absence of coexisting fibrosis in the neighboring uninvolved pancreas offered the only prognostic indicator. The blood flow in cancerous tissue was increased during AT-II infusion, and this was characteristic in the patients whose neighboring uninvolved pancreas had normal parenchyma (nonatrophic) or higher blood flow before AT-II infusion. CONCLUSIONS: Because the AT-II infusion played a role in shifting the blood flow from the surrounding uninvolved pancreas to the cancer tissues, we can speculate that cancer tissues might have thereby received a higher dose of anticancer drugs if the surrounding uninvolved pancreas had been nonfibrotic and more rich in tissue blood flow.
Authors:
Hiroaki Ohigashi; Osamu Ishikawa; Shigekazu Yokayama; Yo Sasaki; Terumasa Yamada; Shingi Imaoka; Akihiko Nakaizumi; Hiroyuki Uehara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgical oncology     Volume:  10     ISSN:  1068-9265     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-06     Completed Date:  2004-02-13     Revised Date:  2007-07-18    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  927-34     Citation Subset:  IM    
Affiliation:
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. oohigasi-hi@mc.pref.osaka.jp
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / drug therapy*,  pathology,  surgery
Adult
Aged
Angiotensin II / administration & dosage,  therapeutic use*
Chi-Square Distribution
Female
Humans
Infusions, Intra-Arterial
Male
Methotrexate / administration & dosage,  therapeutic use
Middle Aged
Pancreatic Neoplasms / drug therapy*,  pathology,  surgery
Prognosis
Statistics, Nonparametric
Survival Analysis
Vasoconstrictor Agents / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 11128-99-7/Angiotensin II; 59-05-2/Methotrexate

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