Sato Yo, Tsuchiya Yoshiaki, Aizawa Masaki, Nomura Tatsuya, Nashimoto Atsushi
Division of Surgery, Niigata Cancer Center Hospital.
Gan To Kagaku Ryoho. 2014 Sep;41(9):1151-4.
We report two cases of pancreatic cancer with multiple liver metastases for which successful gemcitabine (GEM) +S-1 therapy facilitated radical resection. Case 1: A 40-year-old man with jaundice was diagnosed with pancreatic head cancer and multiple metastases. Radical treatment was not possible. Therefore, he was administered GEM +S-1 (GEM 1,000 mg/m² on days 1 and 8; S-1, 100mg/day for 14 days). Administration of seven courses of therapy achieved complete remission (CR) of the metastatic lesions. Considering the possibility of residual tumors, a subtotal stomach-preserving pancreaticoduodenectomy was performed. Although pathological examination revealed a residual tumor in the primary lesion, R0 resection was achieved. GEM+S-1 therapy was resumed, and the patient is currently relapse-free. Case 2: A 65-year-old man with obstructive jaundice was diagnosed with pancreatic head cancer and multiple metastases. Radical treatment was not possible. Therefore, GEM +S-1 therapy was initiated. After 11 therapy courses, only one metastatic lesion remained. Radical treatment was then deemed possible, and a pylorus-preserving pancreaticoduodenectomy was performed. Pathological examination revealed residual tumors in the primary lesion and the peripancreatic lymph nodes. However, the liver nodules were only fibrotic, and their surgical radicality was R0. GEM +S-1 therapy was resumed, and the patient is currently relapse-free.
The high response rate of GEM+S-1 therapy suggests its usefulness in facilitating radical resection after treatment with (GEM) +S-1.
我们报告了两例伴有多发肝转移的胰腺癌病例,吉西他滨(GEM)+S-1治疗成功促使了根治性切除。病例1:一名40岁黄疸男性被诊断为胰头癌伴多发转移。无法进行根治性治疗。因此,给予其GEM +S-1(第1天和第8天给予GEM 1000mg/m²;S-1,100mg/天,共14天)。七个疗程的治疗使转移灶达到完全缓解(CR)。考虑到残留肿瘤的可能性,进行了保留部分胃的胰十二指肠切除术。尽管病理检查显示原发灶有残留肿瘤,但实现了R0切除。恢复GEM+S-1治疗,患者目前无复发。病例2:一名65岁伴有梗阻性黄疸的男性被诊断为胰头癌伴多发转移。无法进行根治性治疗。因此,开始GEM +S-1治疗。11个疗程的治疗后,仅残留一个转移灶。此时认为可以进行根治性治疗,遂进行了保留幽门的胰十二指肠切除术。病理检查显示原发灶和胰周淋巴结有残留肿瘤。然而,肝结节仅为纤维化,手术切缘为R0。恢复GEM +S-1治疗,患者目前无复发。
GEM+S-1治疗的高缓解率表明其在GEM +S-治疗后促进根治性切除方面有用。