Department of Surgery at Keio University School of Medicine, Tokyo, Japan.
Pancreatology. 2010;10(2-3):250-8. doi: 10.1159/000244265. Epub 2010 May 13.
We retrospectively assessed the benefits of 5-fluorouracil (5-FU)- and heparin-based portal infusion chemotherapy combined with systemic administration of mitomycin C (MMC) and cisplatin (CDDP) for 4 weeks following surgery (PI4W). The goal was to determine if this treatment prevented liver metastasis and improved survival for patients with potentially curative resection of pancreatic cancer.
68 patients who underwent pancreatectomy from January 1995 to August 2007 were treated. Of these cases, 22 patients received portal infusion with 5-FU (250 mg/day) for 2 weeks (PI2W) following surgery, while 25 patients received PI4W therapy (250 mg/day of 5-FU with 2,000 IU/day of heparin everyday for 4 weeks, 4 mg MMC on days 6, 13, 20, 27, and 10 mg CDDP on days 7, 14, 21, 28). The remaining 21 patients were treated without adjuvant therapy during the perioperative period.
All patients except one completed the portal infusion chemotherapy without toxicity. The cumulative liver metastasis-free survival rate in the PI4W group was significantly higher than those in the other two groups. Furthermore, in the PI4W group, 3-year survival was 82.9% and 5-year survival was 63.8%, rates which were significantly better than those observed in the other two groups.
PI4W therapy after surgery is feasible and could become a promising adjuvant therapy in patients with potentially curative resection of pancreatic cancer. and IAP.
我们回顾性评估了氟尿嘧啶（5-FU）和肝素门静脉输注化疗联合全身应用丝裂霉素 C（MMC）和顺铂（CDDP）在手术后 4 周（PI4W）的疗效。目的是确定该治疗方案是否可以预防肝转移并改善可切除胰腺癌患者的生存。
1995 年 1 月至 2007 年 8 月期间，我们对 68 例接受胰腺切除术的患者进行了治疗。其中，22 例患者术后接受门静脉输注 5-FU（250mg/天）2 周（PI2W），25 例患者接受 PI4W 治疗（250mg/天的 5-FU 加每天 2000IU 的肝素，共 4 周，6、13、20、27 天给予 4mg MMC，7、14、21、28 天给予 10mg CDDP）。其余 21 例患者在围手术期未接受辅助治疗。
除 1 例患者外，所有患者均完成了门静脉输注化疗，无毒性反应。PI4W 组的累积无肝转移生存率明显高于其他两组。此外，PI4W 组 3 年生存率为 82.9%，5 年生存率为 63.8%，明显优于其他两组。
术后 PI4W 治疗是可行的，可能成为可切除胰腺癌患者有前途的辅助治疗方法。
