Masui Toshihiko, Doi Ryuichiro, Ogawa Kohei, Kami Kazuhiro, Machimoto Takafumi, Seo Satoru, Kawaguchi Yoshiya, Egawa Hiroto, Matsugu Yasuhiro, Uemoto Shinji
Department of Hepato=Biliary Pancreatic Surgery and Transplantation, Kyoto University, Kyoto, Japan.
Hepatogastroenterology. 2011 Sep-Oct;58(110-111):1809-13. doi: 10.5754/hge08054.
A 49-year-old man was admitted to the hospital for the upper abdominal pain and was diagnosed as unresectable pancreatic head cancer because of the invasion around the superior mesenteric artery. He was treated with radiochemotherapy, followed by systemic gemcitabine alone for 3 courses. He was further treated with systemic gemcitabine plus S‑1 combination therapy for 5 courses. CT examination after these treatments showed a dramatic reduction of the tumor at the head of the pancreas and a pancreatoduodenectomy was performed. Pathologically, there was no residual malignant tumor. He has had no recurrent tumor up until now. Several studies of gemcitabine plus S-1 combination therapy show higher response rates for unresectable tumors. The current case indicates the effectiveness of the radiochemotherapy and gemcitabine plus S‑1 combination therapy for locally advanced pancreatic head cancer as a neoadjuvant setting. We consider that multidisciplinary treatment including gemcitabine plus S‑1 therapy may prolong the survival time by curative operation.
一名49岁男性因上腹部疼痛入院，因肠系膜上动脉周围受侵被诊断为不可切除的胰头癌。他接受了放化疗，随后单独使用吉西他滨进行了3个疗程的全身治疗。他又接受了吉西他滨加S-1联合治疗5个疗程。这些治疗后的CT检查显示胰腺头部肿瘤显著缩小，遂进行了胰十二指肠切除术。病理检查显示无残留恶性肿瘤。截至目前，他没有肿瘤复发。多项关于吉西他滨加S-1联合治疗的研究表明，其对不可切除肿瘤的缓解率更高。本病例表明放化疗以及吉西他滨加S-1联合治疗作为新辅助治疗对局部晚期胰头癌有效。我们认为包括吉西他滨加S-1治疗在内的多学科治疗可能通过根治性手术延长生存时间。
