Drisko Jeanne A, Serrano Oscar K, Spruce Lisa R, Chen Qi, Levine Mark
Department of Internal Medicine, Division of KU Integrative Medicine.
Department of Surgery, Division of Transplantation, University of Minnesota, Minneapolis, Minnesota.
Anticancer Drugs. 2018 Apr;29(4):373-379. doi: 10.1097/CAD.0000000000000603.
Pancreatic ductal adenocarcinoma (PDA) has a dismal prognosis and is often discovered at an advanced stage with few therapeutic options. Current conventional regimens for PDA are associated with significant morbidity, decreased quality of life, and a considerable financial burden. As a result, some patients turn to integrative medicine therapies as an alternate option after a diagnosis of PDA. Intravenous pharmacologic ascorbic acid (PAA) is one such treatment. The use of PAA has been passionately debated for many years, but more recent rigorous scientific research has shown that there are significant blood concentration differences when ascorbic acid is given parenterally when compared to oral dosing. This pharmacologic difference appears to be critical for its role in oncology. Here, we report the use of PAA in a patient with poorly differentiated stage IV PDA as an exclusive chemotherapeutic regimen. The patient survived nearly 4 years after diagnosis, with PAA as his sole treatment, and he achieved objective regression of his disease. He died from sepsis and organ failure from a bowel perforation event. This case illustrates the possibility of PAA to effectively control tumor progression and serve as an adjunct to standard of care PDA chemotherapy regimens. Our patient's experience with PAA should be taken into consideration, along with previous research in cell, animal, and clinical experiments to design future treatment trials.
胰腺导管腺癌(PDA)预后不佳,通常在晚期才被发现,治疗选择有限。目前用于PDA的传统治疗方案会导致显著的发病率、生活质量下降以及相当大的经济负担。因此,一些患者在被诊断为PDA后会选择综合医学疗法作为替代方案。静脉注射药理维生素C(PAA)就是这样一种治疗方法。多年来,PAA的使用一直存在激烈争论,但最近更严格的科学研究表明,与口服给药相比,肠胃外给予维生素C时血药浓度存在显著差异。这种药理差异似乎对其在肿瘤学中的作用至关重要。在此,我们报告了一名IV期低分化PDA患者使用PAA作为唯一化疗方案的情况。该患者在诊断后存活了近4年,仅接受PAA治疗,且疾病实现了客观缓解。他死于肠道穿孔事件引发的败血症和器官衰竭。本病例说明了PAA有效控制肿瘤进展并作为PDA标准护理化疗方案辅助治疗的可能性。我们患者使用PAA的经验,连同之前在细胞、动物和临床试验中的研究,应被纳入考虑,以设计未来的治疗试验。