Department of Radiology, Nara Medical University, Kashihara, Japan.
J Vasc Interv Radiol. 2010 Jan;21(1):116-21. doi: 10.1016/j.jvir.2009.09.027.
The purpose of this study was to investigate the potential pharmacokinetic advantage of pancreatic arterial infusion chemotherapy of 5-fluorouracil (5-FU) with temporary unification of the pancreatic blood supply for advanced pancreatic cancer in an animal model.
Nine pigs were divided into three groups of three pigs each. 5-FU (20 mg/kg) was infused via jugular vein (group I), celiac artery (group II), and celiac artery with balloon occlusion of the superior mesenteric artery (SMA; group III). At 0, 10, 30, and 60 minutes after drug infusion, the concentrations of 5-FU were measured in plasma and tissues including the liver, pancreatic head, pancreatic uncinate process, and duodenum. Areas under the concentration-time curve (AUCs) were calculated and statistically compared.
The temporary unification of the pancreatic blood supply by converting from dual blood supply through the celiac artery and SMA into a single celiac arterial supply was confirmed by dye injection. Mean AUCs in the pancreas head and liver were significantly higher for groups II and III compared with group I (P < .05). In contrast, there were no significant differences in plasma 5-FU concentrations between groups. In addition, the AUC in the pancreatic uncinate process was significantly higher for group III compared with groups I and II (P < .05).
Pancreatic arterial infusion chemotherapy allows efficient regional drug delivery into the pancreas and liver. Importantly, the unification of the pancreatic blood supply may be required to induce maximum efficacy of arterial infusion chemotherapy for the tumor in the pancreatic uncinate process.
本研究旨在探讨在动物模型中，通过临时统一胰腺血供，对晚期胰腺癌行胰腺动脉输注氟尿嘧啶（5-FU）化疗的潜在药代动力学优势。
9 头猪分为 3 组，每组 3 头。经颈静脉（I 组）、腹腔动脉（II 组）和腹腔动脉联合肠系膜上动脉（SMA）球囊阻断（III 组）输注 5-FU（20mg/kg）。在药物输注后 0、10、30 和 60 分钟，测量血浆和包括肝、胰头部、胰钩突和十二指肠在内的组织中的 5-FU 浓度。计算浓度-时间曲线下面积（AUCs）并进行统计学比较。
通过将胰腺的双重血供（腹腔动脉和 SMA）转换为单一的腹腔动脉供应，实现了胰腺血供的临时统一，通过染料注射得到了证实。与 I 组相比，II 组和 III 组胰头部和肝脏的平均 AUC 显著升高（P<0.05）。相比之下，各组之间血浆 5-FU 浓度无显著差异。此外，III 组胰钩突的 AUC 明显高于 I 组和 II 组（P<0.05）。
胰腺动脉输注化疗可使药物高效递送至胰腺和肝脏。重要的是，为了使胰腺钩突处肿瘤的动脉内化疗达到最大疗效，可能需要统一胰腺血供。
