Evaluation of Intra-Arterial Chemotherapy Safety by Using of Gemcitabine and Oxaliplatin in Combined Treatment of Pancreatic Head Adenocarcinoma

Aim. To evaluate safety of perioperative regional chemotherapy in combined treatment of ductal adenocarcinoma of the pancreatic head. Material and Methods. 53 patients underwent neoadjuvant regional chemotherapy, R0-surgery and adjuvant regional chemotherapy courses. Regional chemotherapy was performed by administration of gemcitabine in a suspension of lipiodol into gastroduodenal artery that was supplemented by oxaliplatine infusion. After that complete blood cell count, biochemical and coagulation examination were made. Toxicity evaluation was conducted according to Common Toxicity Criteria. Postoperative complications, hospital-stay in groups of combined therapy (group A) and isolated surgery (group B) were compared. Results. There were no complications after angiography and catheterization. Postembolization syndrome arose in 10 (18.8%) patients, hematologic toxicity – in 13 (24.5%) cases (Common Toxicity Criteria score 1–2). Anemia was observed in 5 (9%) patients, neutropenia – in 2 (4%) and trombocytopeniya in 1 case. Nausea appeared in 11 (20.7%) patients, vomiting – in 10 (18.8%) cases. Postoperative complications in group A occurred in 20 (38%) cases, in group B – in 20 (37%) cases. Incidence of postoperative complications was similar in both groups. Mean hospital-stay was 18 days in group A and 16 days in group B. At the stage of adjuvant chemotherapy toxic effects were rare and did not require reducing the dose or abrogation of the drug. Conclusion. Regional chemotherapy with gemcitabine and oxaliplatin may be considered safe stage in combined treatment of pancreatic head adenocarcinoma. Further investigations are necessary to assess an effectiveness of treatment.