Tokairin Yutaka, Iida Michio, Yamazaki Shigeru
Dept. of Surgery, Ohta Nishinouchi Hospital.
Gan To Kagaku Ryoho. 2008 Nov;35(12):2123-5.
A 57-year-old man who had brown urine, jaundice and appetite loss from June 2006 was diagnosed with advanced pancreatic cancer. He received pylorus-preserving pancreatoduodenectomy in July 2006. Liver metastasis in S6 lesion was revealed by abdomen CT and SPIO-MRI in November and December 2006, respectively. Chemotherapy with gemcitabine hydrochloride (GEM) 1,400 mg/body was administered once a week on days 1, 8 and 15 for 4 weeks. At the beginning of this chemotherapy, it seemed to be a stable disease, but abdominal CT revealed a tumor progress in April 2007. So we selected combination chemotherapy with GEM and S-1 as second-line. At first serum CA19-9 was decreased but gradually increased, and the CT scan revealed the tumor progression in the liver and the local recurrence appeared in February 2008. So we selected combination chemotherapy with GEM and nedaplatin as third-line. After 2 months, CT scan revealed no change in tumor size. This combination chemotherapy can be effective in some patients with GEM-refractory pancreatic cancer.
一名57岁男性，自2006年6月起出现茶色尿、黄疸及食欲减退症状，被诊断为晚期胰腺癌。2006年7月，他接受了保留幽门的胰十二指肠切除术。2006年11月和12月，腹部CT及超顺磁性氧化铁磁共振成像（SPIO-MRI）分别显示其肝脏S6区出现转移灶。自2006年11月起，给予盐酸吉西他滨（GEM）1400mg/体，每周1次，于第1、8、15天给药，共4周。化疗开始时病情似乎稳定，但2007年4月腹部CT显示肿瘤进展。因此，我们选择吉西他滨与S-1联合化疗作为二线治疗方案。起初血清CA19-9有所下降，但随后逐渐升高，2008年2月CT扫描显示肝脏肿瘤进展且出现局部复发。于是我们选择吉西他滨与奈达铂联合化疗作为三线治疗方案。2个月后，CT扫描显示肿瘤大小无变化。这种联合化疗对部分吉西他滨难治性胰腺癌患者可能有效。
