Ishikawa Toru
Department of Gastroenterology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan.
World J Gastroenterol. 2007 Aug 28;13(32):4306-9. doi: 10.3748/wjg.v13.i32.4306.
Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic. Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However, the response rates have been highly variable, and are often irreproducible. To improve this low response rate, various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug, generating higher local drug concentrations in tumor cells with lower toxicity. Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and, simultaneously, a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.
无法切除的胰腺癌预后极差且具有化疗耐药性。胰腺癌的治疗仍然存在问题。吉西他滨是一种有前景的新型药物,最近已被用于晚期胰腺癌的姑息治疗研究。然而,缓解率差异很大,且往往不可重复。由于不存在标准治疗方法,因此需要各种治疗来提高这种低缓解率。动脉内化疗被认为可利用药物的首过效应,在肿瘤细胞中产生更高的局部药物浓度,同时毒性更低。与全身给予抗肿瘤药物相比,区域动脉内化疗可能在肿瘤内提供高水平的细胞生长抑制浓度,同时全身副作用发生率较低。动脉内化疗已被引入作为晚期胰腺癌的替代治疗方法。这种方法的进一步临床试验应针对晚期胰腺癌进行前瞻性随机对照研究。