title: [A case of locally advanced pancreatic cancer with hepatic artery invasion treated with neoadjuvant chemoradiotherapy].
abstract: A 64-year-old man with a high serum level of cancer antigen 19-9 (CA19-9) was diagnosed with pancreatic head cancer by computed tomography. Because the tumor was found to have directly invaded the hepatic artery for long segment on laparotomy, we diagnosed it as an unresectable locally advanced pancreatic cancer. Radiation therapy( 50.4 Gy/28 Fr) with gemcitabine( GEM)( 1,000 mg/m2 on days 1, 8, and 15, every 4 weeks) for 3 courses was administered. Subsequently, additional systemic chemotherapy with GEM( 800 mg/m2 on days 1 and 15, every 3 weeks) and S-1( 100 mg/body on days 1-14, every 3 weeks) was administered for 4 courses. After the treatment, the main tumor shrunk without distant metastasis. Thus, we performed pancreaticoduodenectomy with resection of the common hepatic artery. An end-to-end microvascular anastomosis was made between the left gastric artery and the right hepatic artery. Pathological examination revealed that > 90% of the tumor cells had disappeared and confirmed a negative margin status (R0). Eight months postoperatively, the patient is healthy and shows no signs of recurrence.
authors.affiliation: Dept. of Surgical Oncology, Osaka City University Graduate School of Medicine.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Murata
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Amano
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Hirata
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nagahara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Naoshi
authors.initials: N
authors.lastname: Kubo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kazuya
authors.initials: K
authors.lastname: Muguruma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otani
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maeda
authors.forename: Masaichi
authors.initials: M
authors.lastname: Ohira
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D006499:Hepatic Artery / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D010094:Oxonic Acid / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D016577:Pancreaticoduodenectomy; D005641:Tegafur / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine