title: [Continuous treatment with S-1, an effective strategy for an older adult with unresectable advanced pancreatic cancer with peritoneal dissemination-a case report].
abstract: The prognosis for advanced pancreatic cancer with peritoneal dissemination is extremely poor, and no effective standard therapy has been established. We present a case of a very old patient whose QOL improved shortly after administration of only S-1 to treat advanced pancreatic cancer with peritoneal dissemination. A 85-year-old man presented to our hospital with anorexia and loss of weight. CT scanning showed severe ascites and a low-density area 2 cm wide at the tail of the pancreas. Ascitic cytology revealed adenocarcinoma and carcinomatous peritonitis due to pancreatic cancer. Considering his general condition due to old age, the regimen for oral S-1 (80 mg/body/day) was set at 4 consecutive weeks of administration followed by a 2-week rest period. His abdominal circumference decreased and his appetite improved by 14 days following commencement of the therapy. The blood examination one month following commencement showed a significant decrease in the tumor marker. There was no adverse drug reaction. Six months later CT scanning showed that the ascites had disappeared and that the low-density area at the tail of the pancreas had become less obvious. The tumor marker and biochemical parameters were within standard ranges. Twelve months since the therapy began: there still has been no adverse drug reaction and his QOL has been good. He is receiving the therapy as an outpatient. This case suggests that S-1 is a safe and effective drug for very elderly patients.
authors.affiliation: Dept. of Surgery, Shinshiro Municipal Hospital.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Okamoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inaba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000284:Administration, Oral; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010537:Peritoneum / Q000473:pathology; D010538:Peritonitis / Q000209:etiology; D011788:Quality of Life; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid