Hepatic Artery Infusion of Floxuridine in Combination With Systemic Chemotherapy for Pancreatic Cancer Liver Metastasis: A Propensity Score-Matched Analysis in Two Centers

Frontiers in Oncology

Jiemin Zhao¹  Weiguang Qiang¹  Xiaodong Li¹  Hongbing Shi¹  Bin Xu²  Fei Liu³  Tianming Wang³  Juxiong Xiao³  Haiping Li³  Gang Li³  Chunhui Zhou³  Changyong Chen³  Changli Peng⁴  Liangrong Shi⁴ 

[1] Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China;Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou, China;Interventional Radiology Center, Department of Radiology, Xiangya Hospital Central South University, Changsha, China;Research Center for Geriatric Disorder, Xiangya Hospital Central South University, Changsha, China;

关键词: pancreatic cancer;    liver metastasis;    hepatic artery infusion;    floxuridine;    propensity score;   

DOI  :  10.3389/fonc.2021.652426

来源: DOAJ

【 摘 要 】

AimTo evaluate the efficacy of hepatic artery infusion (HAI) of floxuridine (FUDR) in combination with systemic chemotherapy in patients with pancreatic cancer liver metastases (PCLM).Patients and MethodsWe retrospectively collected clinical data of 347 patients with PCLM who underwent first-line chemotherapy at two Chinese centers between 2012 and 2019. Propensity score matching between patients with and without HAI was performed to compensate for differences in baseline characteristics. Objective response rate (ORR) and overall survival (OS) between groups were compared. HAI pump functionality was recorded.ResultsData of 258 patients (62 patients with HAI and 196 patients without HAI) were used for matching. After 1:1 ratio matching, 62 patients per group were included. The intrahepatic ORR was 66.1% in the HAI group and 22.6% in the non-HAI group (P < 0.001), and the extrahepatic ORR was 25.0 versus 28.9% (P = 0.679). The median OS was significantly longer in HAI group (14.0 versus 10.8 months, P = 0.001). Multivariance COX regression showed HAI led to a decrease in hazard ratio for death by 61.8% (HR = 0.382; 95% CI: 0.252–0.578; P< 0.001). Subgroup analysis revealed that patients without EHM, with higher intrahepatic tumor burden and with synchronous liver metastasis benefited more from HAI. Dysfunction of HAI pump occurred in 5.7% of patients during the period of follow-up.ConclusionsIn patients with PCLM, first-line treatment with HAI FUDR plus SCT resulted in higher intrahepatic response and better OS.

【 授权许可】

Unknown