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[1例吉西他滨成功治疗胰腺导管癌肝转移病例]

[A case of liver metastasis of pancreatic duct carcinoma successfully treated with gemcitabine].

作者信息

Tsujie Masanori, Nakamori Shoji, Nakazuru Shoichi, Hayashi Nobuyasu, Okami Jiro, Nagano Hiroaki, Dono Keizo, Umeshita Koji, Sakon Masato, Monden Morito

机构信息

Dept. of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University.

出版信息

Gan To Kagaku Ryoho. 2003 Feb;30(2):297-301.

Abstract

We report a patient in whom systemic chemotherapy using gemcitabine was effective against liver metastases of pancreatic cancer. A 72-year-old woman underwent pancreatoduodenectomy with lymphadenectomy and partial resection of the portal vein following a diagnosis of pancreatic cancer, and her postoperative course was uneventful. The diagnosis was stage III anaplastic ductal carcinoma (t2n1P0H0M0). One year and 3 months after the operation, however, her serum level of carbohydrate antigen 19-9 (CA19-9) was found to be elevated, and CT examination revealed a mass in the liver that was diagnosed as liver that was metastases. Systemic chemotherapy was performed with a regimen of gemcitabine 600 mg/m2/week for 3 weeks, followed by a week rest, for the first three courses. On and after fourth course, gemcitabine 1,000 mg/m2/week was administered. The serum CA19-9 level was down from 882 U/ml to normal after 5 courses of chemotherapy and CT examination revealed that liver metastases had completely vanished. Although no evidence of deterioration was observed, the patient died of infectious pneumonia 10 months after recurrence. The prognosis of liver metastases of pancreatic cancer is quite unfavorable. However, if remission is achieved with gemcitabine, the patient has the possibility to obtain a better outcome.

摘要

我们报告了一名使用吉西他滨进行全身化疗对胰腺癌肝转移有效的患者。一名72岁女性在被诊断为胰腺癌后接受了胰十二指肠切除术、淋巴结清扫术及门静脉部分切除术,术后恢复顺利。诊断为III期间变性导管癌(t2n1P0H0M0)。然而,术后1年零3个月时,发现她的血清糖类抗原19-9(CA19-9)水平升高,CT检查显示肝脏有一个肿块,被诊断为肝转移。前三个疗程采用吉西他滨600mg/m²/周的方案进行全身化疗,持续3周,随后休息1周。从第四个疗程开始及之后,给予吉西他滨1000mg/m²/周。经过5个疗程的化疗后,血清CA19-9水平从882U/ml降至正常,CT检查显示肝转移已完全消失。尽管未观察到病情恶化的迹象,但患者在复发后10个月死于感染性肺炎。胰腺癌肝转移的预后相当不佳。然而,如果使用吉西他滨实现缓解,患者有可能获得更好的结果。

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