Egawa Tomohisa, Nagashima Atsushi, Kitano Mitsuhide, Doi Masakazu, Hayashi Shinobu, Yoshii Hiroshi
Dept. of Surgery, Saiseikai Kanagawaken Hospital.
Gan To Kagaku Ryoho. 2004 Oct;31(11):1932-4.
A 67-year-old woman visited our hospital with a chief complaint of epigastralgia. The patient was diagnosed as having unresectable pancreatic cancer because abdominal CT and angiography revealed a tumor that had invaded a common bile duct, portal vein and superior mesenteric vein. A palliative operation was performed because of obstructive jaundice. Peritoneal dissemination was observed and confirmed pathologically. The patient was treated with gemcitabine after the palliative operation. A gemcitabine 30 min i.v. infusion at a starting dose of 1,000 mg/m2 was administered once a week for 3 weeks with a 1-week rest. The patient experienced grade 2 leukocytopenia, so the dose of gemcitabine was reduced to continue the chemotherapy. The patient continued to undergo the palliative chemotherapy without severe adverse effects. As a result, the patient was in tumor dormancy for 15 months. It is important for the patient to induce an acceptable level of toxicity in clinical practice and to continue the chemotherapy.