[A case of advanced pancreas cancer successfully treated by using combined modality therapy].
A 62-year-old woman visited a nearby hospital with chief complaints of diarrhea and weight loss.A computed tomography (CT)scan showed a hypovascular tumor approximately 2 cm in diameter in the pancreatic uncus, and the patient was referred to our department for thorough examination and treatment.The patient was diagnosed with cT4 (A) N0M0, cStage IV a cancer of the pancreatic uncus.The treatment consisted of 3 weeks of gemcitabine and 1 week of drug withdrawal; after completion of 4 courses, concomitant administration of S-1 (ie GS therapy) was initiated.The tumor gradually shrank, and it was not observed on a CT scan 1 year and 8 months later.Although no obvious distant metastasis was observed, a low density area around the superior mesenteric artery still remained.Possibility of viable tumor could not be completely ruled out; therefore, a pancreaticoduodenectomy was scheduled.However, because sclerosis around the superior mesenteric artery was quite severe, bled easily, and was difficult to separate, we decided that excision was impossible and resumed the GS therapy. The primary lung cancer that developed subsequently was resected, and the GS therapy was continued.The tumor in the pancreatic uncus was resected after growth was observed 3 years and 9 months after the initiation of chemotherapy.The patient is currently receiving chemotherapy as an outpatient.
Dept. of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine.
Yutaka
Y
Sunose
Izumi
I
Takeyoshi
Keitaro
K
Hirai
Takamichi
T
Igarashi
Kengo
K
Takahashi
Hotaka
H
Yamazaki
Kazumi
K
Tanaka
Norifumi
N
Takahashi
Hiroshi
H
Tsukagoshi
Hiroomi
H
Ogawa
Daisuke
D
Yoshinari
Hideaki
H
Yokoo
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage; D000093542:Gemcitabine
D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine