| Intra-arterial infusion chemotherapy with angiotensin-II for locally advanced and nonresectable pancreatic adenocarcinoma: further evaluation and prognostic implications. | |
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MedLine Citation:
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PMID: 14527913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Hiroaki Ohigashi; Osamu Ishikawa; Shigekazu Yokayama; Yo Sasaki; Terumasa Yamada; Shingi Imaoka; Akihiko Nakaizumi; Hiroyuki Uehara |
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19870793 - The effect of the pulse upon the formation and flow of lymph. 7050343 - Effect of prostaglandins on pancreatic circulation in anesthetized dogs. 19870793 - The effect of the pulse upon the formation and flow of lymph. |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of surgical oncology Volume: 10 ISSN: 1068-9265 ISO Abbreviation: Ann. Surg. Oncol. Publication Date: 2003 Oct |
Date Detail:
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Created Date: 2003-10-06 Completed Date: 2004-02-13 Revised Date: 2007-07-18 |
Medline Journal Info:
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Nlm Unique ID: 9420840 Medline TA: Ann Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 927-34 Citation Subset: IM |
Affiliation:
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Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. oohigasi-hi@mc.pref.osaka.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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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:
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0/Vasoconstrictor Agents; 11128-99-7/Angiotensin II; 59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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