Abstract: Background and purpose: Intravenous chemotherapy of nab-paclitaxel combined with gemcitabine (AG) is one of the effective treatment options for advanced pancreatic cancer, and transcatheter arterial chemotherapy (TAC) has the advantage of enhancing efficacy and reducing side effects. This study aimed to evaluate the efficacy and safety of AG regimen in the treatment of advanced pancreatic cancer by transcatheter arterial chemotherapy/chemoembolization (TAC/TACE). Methods: We retrospectively analyzed 63 advanced pancreatic cancer patients who were treated at Fudan University Shanghai Cancer Center from Jan. 2016 to Jun. 2019. All patients received arterial infusion chemotherapy and/or embolization, and the TAC regimen consisted of nab-paclitaxel 125 mg/m ² combined with gemcitabine hydrochloride 1 000 mg/m ² , perfusion ≥10 minutes. If accompanied by liver metastasis, embolization was implemented. Results: Among 63 patients, the arterial blood supply ratios of pancreatic tumors and liver metastases in digital subtraction angiography (DSA) were 66.67% and 35.29% respectively. Four patients received treatment once, 6 patients received treatment twice, 6 patients received treatment 3 times, and 47 patients received treatment 4 times or more. The maximum number of treatment was 9 times, with an interval of 21-45 d. The 1-year overall survival (OS) rate was 36.51%. Median OS (mOS) was 9.2 months. The 6-month progression-free survival (PFS) rate was 44.44%, and the median PFS (mPFS) was 4.7 months. Multivariate analysis showed that KPS≥80 and stage Ⅲ were associated with longer survival, and multiple TAC/TACE treatment was suggested as good prognostic factor. Conclusion: AG has better safety in the treatment of pancreatic cancer by transarterial infusion chemotherapy. Compared with intravenous chemotherapy, AG can reduce the adverse reactions, effectively control the disease and prolong patients' survival.

Key words: Pancreatic cancer, Transcatheter arterial chemotherapy, Safety, Effectiveness, AG regimen