Abstract:

Objective

This study sought to retrospectively analyze the efficacy and safety of a port-catheter drug delivery system（PCS）implanted via left subclavian artery for gemcitabine administration during the treatment of advanced pancreatic cancer.

Methods

Eighty patients with advanced pancreatic cancer who met our inclusion criteria were enrolled in the study and received gemcitabine through a PCS.We retrospectively analyzed the clinical benefit response（CBR），tumor objective response rate（ORR），overall survival（OS），drug toxicity，and surgical complications.

Results

The CBR rate was 56%（45/80）and mainly manifested as pain relief and reduced analgesic drug use.Among the 80 patients enrolled，62 patients could be evaluated，yielding the following results：9 cases had a partial response（11.25%），27 cases had stable disease（33.75%）and 16 cases developed progressive disease（20.00%）.The ORR was 11.25%and the disease control rate was 45%.The median survival time was 160 days，and the 1-year survival rate was 23.3%.Univariate and multivariate Cox proportional hazards models for predictors of OS showed that obstructive jaundice，ECOG score，number of chemotherapy treatments，and metastasis were independent factors that affected the prognosis of patients with advanced pancreatic cancer.Drug toxicity manifested mainly as mild bone marrow suppression，nausea，and vomiting.The most common interventional complication was port-catheter blockage（2.5%（2/80）.

Conclusions

Interventional chemotherapy via a PCS can significantly increase the CBR of patients，improve quality of life，and reduce systemic toxicity.Thus，this approach can be considered a safe and effective treatment for advanced pancreatic cancer.

Key words: Pancreatic cancer, Subclavian artery port-catheter implantation, Gemcitabine, Chemotherapy