title: [Two cases of advanced pancreatic cancer responding to gemcitabine with long survival of 2 years].
abstract: Gemcitabine (GEM) is currently considered a standard drug for advanced pancreatic cancer and widely used for patients with this carcinoma. We report on 2 patients with unresectable pancreatic cancer who were able to survive for more than 2 years after GEM treatments. Case 1 was a 82-year-old woman with invasion to celiac artery and who was inoperable. During GEM administration, she had no symptoms and the tumor did not progress. However, because of the toxicities of heart failure, GEM administration was stopped after she took a total of 16,800 mg. After GEM administration was stopped, symptoms appeared and the tumor progressed. Case 2 was a 39-year-old man with obstructive jaundice with liver and lymph node metastases. He was treated with metallic stent in order to reduce cholestasis. During GEM administration, he had no symptoms and the tumor did not progress. As an adverse event, rash occurred after he took a total of 51,800 mg. GEM administration was then stopped. This patient sometimes developed cholestasis due to tumor ingrowths and sludge and was treated successful by endoscopy. GEM has shown to improve survival and show a clinically beneficial response in patients with advanced pancreatic cancer. However, toxic events can be expected to occur with long term GEM administration. We consider that management of complications such as obstructive jaundice is very important in the treatment of pancreatic cancer.
authors.affiliation: Dept. of Gastroenterology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yajima
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Furukawa
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ishii
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hattori
authors.forename: Nori
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamaoka
authors.forename: Megumu
authors.initials: M
authors.lastname: Fujihara
authors.forename: Mikio
authors.initials: M
authors.lastname: Fujita
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kuniki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D002779:Cholestasis / Q000209:etiology / Q000628:therapy; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000628:therapy; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015607:Stents; D017741:Survivors; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C096910:UFT(R) drug; D003841:Deoxycytidine; D005641:Tegafur; D014498:Uracil; D000093542:Gemcitabine