Katsura Yoshiteru, Takeda Yutaka, Ohmura Yoshiaki, Motoyama Yurina, Ishida Tomo, Morimoto Yoshihiro, Matsushita Katsunori, Naito Atsushi, Murakami Kohei, Kagawa Yoshinori, Okishiro Masatsugu, Takeno Atsushi, Egawa Chiyomi, Kato Takeshi, Tamura Shigeyuki
Dept. of Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2015 Nov;42(12):2367-9.
Pancreatic ductal carcinoma is a highly aggressive cancer, with one of the highest mortality rates among gastrointestinal cancers. Nab-paclitaxel plus gemcitabine (GEM) significantly improved overall survival, progression-free survival, and response rate in a phase Ⅲ trial in 151 community and academic centers in 11 countries. As a result, nab-paclitaxel plus GEM was approved for use in December 2014 in Japan. We report a case of a patient with pancreatic cancer who underwent this chemotherapy. A 47-year-old man was admitted to our hospital for evaluation of pancreatic lesions. Computed tomography revealed a hypoattenuating tumor in the body of the pancreas. After the patient underwent preoperative chemoradiotherapy under the diagnosis of cStage Ⅳa cancer, we planned to perform distal pancreatectomy. However, this case was inoperable because we found 3 liver metastases during surgery. On postoperative day 14, we treated the patient with nab-paclitaxel plus GEM. Grade 2 toxicities included neutropenia, diarrhea, and peripheral neuropathy, but serious adverse events did not occur. The progression-free survival was 5 months. He remained alive for 7 months after the chemotherapy. In patients with metastatic pancreatic adenocarcinoma, nab-paclitaxel plus GEM can be considered as the standard treatment.
胰腺导管癌是一种侵袭性很强的癌症，在胃肠道癌症中死亡率极高。在一项由11个国家的151个社区和学术中心参与的Ⅲ期试验中，纳米白蛋白结合型紫杉醇联合吉西他滨（GEM）显著提高了总生存期、无进展生存期和缓解率。因此，纳米白蛋白结合型紫杉醇联合GEM于2014年12月在日本获批使用。我们报告了一例接受这种化疗的胰腺癌患者。一名47岁男性因胰腺病变入院接受评估。计算机断层扫描显示胰腺体部有一个低密度肿瘤。在该患者被诊断为cⅣa期癌症后接受了术前放化疗，之后我们计划进行胰体尾切除术。然而，由于手术中发现3处肝转移，该病例无法进行手术。术后第14天，我们用纳米白蛋白结合型紫杉醇联合GEM对患者进行治疗。2级毒性反应包括中性粒细胞减少、腹泻和周围神经病变，但未发生严重不良事件。无进展生存期为5个月。化疗后他存活了7个月。对于转移性胰腺腺癌患者，纳米白蛋白结合型紫杉醇联合GEM可被视为标准治疗方案。
