[A case of locally advanced pancreatic cancer with superior membrane artery invasion successfully resected after gemcitabine-based chemoradiotherapy].
A 69-year-old man with chief complaint of epigastralgia was diagnosed as locally advanced borderline unresectable pancreatic head cancer that involved superior membrane artery (SMA). Gemcitabine (GEM) -based chemoradiotherapy (CRT) was administered for consecutive 3 weeks in the following fashion: continuous twice-a-day accelerated radiotherapy (2 daily fractions of 1.5 Gy, 5 days a week, with a 6-hr minimal interval between fractions) with 3-time weekly intravenous infusions of GEM. Total radiation dose was 45 Gy and GEM was given on days 1, 8 and 15 at dose of 800 mg/m2. After the completion of CRT, the involvement of SMA remained. Next, additional systemic chemotherapy with GEM was performed for 3 weeks in the following fashion: weekly intravenous infusions of GEM at dose of 1,000 mg/m2. Finally, the main tumor and the invasion to SMA were reduced. Surgical resection with negative margins (R0 resection) was performed. Adjuvant chemotherapy with 6 courses of GEM was also performed. The patient has no recurrence, suggesting the efficacy of GEM-based CRT for locally advanced borderline unresectable pancreatic cancer.
Ohmura
Yoshiaki
Y
Department of Surgery, Graduate School of Medicine, Osaka University, and Osaka National Hospital, National Hospital Organization.
Takeda
Yutaka
Y
Nagano
Hiroaki
H
Nakamori
Shoji
S
Kobayashi
Shogo
S
Marubashi
Shigeru
S
Eguchi
Hidetoshi
H
Tanemura
Masahiro
M
Kitagawa
Toru
T
Monden
Morito
M
Mori
Masaki
M
Doki
Yuichiro
Y
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000628:therapy*; D011878:Radiotherapy / Q000379:methods; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine