Regional versus systemic chemotherapy for advanced pancreatic cancer: a randomized study

Abstract

Background/aims: In an attempt to improve treatment protocols for advanced pancreatic cancer, the value of regional chemotherapy compared with systemic chemotherapy was investigated in this randomized study.

Methodology: Fourteen patients with advanced non-resectable pancreatic adenocarcinoma were randomized receiving either systemic chemotherapy with mitomycin, mitoxanthrone and cisplatin (5pts.) or celiac axis infusion regional chemotherapy with SpherexR microembolization. In the systemic group one patient was stage III, four patients were stage IV, in the intraarterial group two patients were specified stage III and seven were stage IV.

Results: In the systemic group one stable disease and four progressive diseases were noted, in the regional group two stable diseases and seven partial responses were noted. Median survival was 11 weeks in the systemically treated patients versus 33 weeks in the patients treated with intraarterial infusion (p=0.001). One patient became resectable (R0).

Conclusions: Performance status improved during regional chemotherapy whilst it steadily decreased in the patients treated systemically. The study was terminated at that point.