title: [A case of recurrent pancreatic cancer effectively responding to S-1 combined irinotecan third-line chemotherapy with PSK].
abstract: A case of recurrent pancreatic cancer effectively responded to S-1 and irinotecan combined with third-line chemotherapy (IRIS) with PSK. The patient was a 75-year-old female. In October 2007, a pancreatoduodenectomy was performed, followed with 6 courses of systemic adjuvant chemotherapy of gemcitabine (GEM). Three months after finishing the adjuvant chemotherapy, a recurrence of para-aortic lymph node metastasis was confirmed. We resumed the second-line chemotherapy of S-1/GEM (GS) with PSK. GS therapy was continued for about 3 years, until the recurrent lesion was found to have increased after 30 courses. Nevertheless, we continued up to 39 courses. In November 2011, we started third-line chemotherapy using S-1/irinotecan (IRIS) with PSK. The regimen was S-1 of 80 mg/body/day, continuously administered for day 1-14th, followed by a discontinuation for 2 weeks. CPT-11 100 mg/body/day was administered on day 1 and 15th; and PSK of 3 g/ body/day was continued, until it resulted in increased recurrent lesions. After the end of 4 courses, recurrent lesions started to respond partially. Currently, the patient is being treated as an outpatient. This case indicates that IRIS (S-1/CPT-11) is an effective therapy when pancreatic cancer fails to respond to GS therapy.
authors.affiliation: Dept. of Gastroenterological Surgery, St. Marianna University.
authors.forename: Osamu
authors.initials: O
authors.lastname: Saji
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Ishii
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Ken
authors.initials: K
authors.lastname: Sumiyoshi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asano
authors.forename: Keigo
authors.initials: K
authors.lastname: Iwata
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Okamura
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koizumi
authors.forename: Takehito
authors.initials: T
authors.lastname: Otsubo
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008207:Lymphatic Metastasis; D010094:Oxonic Acid / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D011509:Proteoglycans / Q000008:administration & dosage; D012008:Recurrence; D016879:Salvage Therapy; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D011509:Proteoglycans; C079198:S 1 (combination); D005641:Tegafur; C010770:polysaccharide-K; D010094:Oxonic Acid; D000077146:Irinotecan; D002166:Camptothecin