Efficacy Of Verapamil Combined With Chemotherapeutic Agents In Interventional Therapy Of Advanced Stage Of Pancreatic Cancer

Background:Pancreatic cancer is one of the cancers with the lowest survival rate.Although early pancreatic cancer is expected to be cured by radical resection,most of the patients will lose the chance of operation once found.At present,there is no effective treatment for advanced pancreatic cancer,the drug treatment effect is very poor,and the overall survival rate has not improved significantly for decades.Drug resistance is considered to be the main reason for the poor treatment effect of most pancreatic cancer.Therefore,overcoming the drug resistance of pancreatic cancer is very important to improve the clinical efficacy and prolong the survival time of pancreatic cancer.Verapamil is an effective calcium channel blocker(CCB),which can significantly reverse MDR of tumor cells.Verapamil is one of the calcium channel blockers.It has a significant role in reversing multidrag resistance(MDR)of tumor cells.It can be used as the substrate of drug-resistant "pump" and competitively combine with P-glycoprotein on the cell membrane to inhibit P-glycoprotein,so as to improve the concentration of anti-tumor drugs in cells and effectively overcome MDR of tumor cells.However,when the intravenous dosage of verapamil reaches 1-2?mol/L,patients will suffer adverse reactions such as heart rate decline,which is the key reason to limit the wide use of verapamil in clinical practice.The concentration of verapamil in the local tissue can reach 3-10 times of that in the blood.Verapamil can form the local concentration which can reverse the drug resistance in the safe range of venous concentration.It can not only reverse the drug-resistant concentration of the tumor,but also avoid the side effects on the heart.In order to explore ways to further improve the therapeutic effect of advanced pancreatic cancer,this paper carried out a clinical study on the interventional treatment of advanced pancreatic cancer by target arterial infusion of verapamil combined with chemotherapy drugs.Finally,the therapeutic effect of this project was analyzed by comparing the clinical data of the two groups(observation group and control group).Purpose:To evaluate the efficacy of target artery infusion of verapamil combined with chemotherapy in interventional therapy of advanced stage of pancreatic cancer.Methods:68 patients with advanced pancreatic cancer admitted to our department from January 2012 to December 2016 were enrolled in the study.In addition,these 68 patients were randomly divided into control group(n=35)treated by target artery infusion of chemotherapy,and observation group(n=33)treated by target artery infusion of verapamil combined with chemotherapy.Every patient was treated at least twice,then the total effectiveness rate(complete remission(CR)and partial remission(PR),CR+PR),clinical profit,drug toxicity and cardiovascular toxicity were evaluated,and followed up overall survival(OS)rate.Results:1.Primary focus of pancreatic cancer:the effective rate(CR+PR)of the observation group was 69.6%,of which CR was 0%,PR was 69.6%;the effective rate(CR+PR)of the control group was 48.5%,of which CR was 0%,PR was 48.5%.The effect of the observation group was significantly better than that of the control group.2.Liver metastases:the effective rate(CR+PR)of the observation group was 73.9%,in which CR was 0%,PR was 73.9%;the effective rate(CR+PR)of the control group was 52%,in which CR was 0%,PR was 52%.The effect of the observation group was significantly better than that of the control group.3.Clinical benefit evaluation:the KPS score of the observation group was positive in 25 cases,pain in 24 cases,and weight in 20 cases;the KPS score of the control group was positive in 20 cases,pain in 13 cases,and weight in 12 cases.The clinical benefit of the observation group was significantly better than that of the control group.4.Survival analysis:the median PFS of the control group and the observation group was 6 and 9 months,and the median OS was 11 and 15 months.The median PFS and the median OS of the observation group were significantly longer than those of the control group(P<0.01).5.Adverse reactions:all patients in the observation group did not have serious adverse reactions,and there was no significant change in cardiac function and ECG before and after treatment.Conclusion:The interventional therapy of verapamil combined with chemotherapy drugs for advanced pancreatic cancer can significantly improve the curative effect of pancreatic cancer,improve the quality of life of patients with advanced pancreatic cancer,prolong the survival time of patients,and do not increase chemotherapy drugs and cardiovascular adverse reactions of patients.