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一名转移性胰腺癌患者采用FOLFIRINOX/丝裂霉素、高剂量、可诱导发热的欧洲白蜡树提取物治疗并随后进行R0切除后实现长期无瘤生存:一例报告

Long-term tumor-free survival in a metastatic pancreatic carcinoma patient with FOLFIRINOX/Mitomycin, high-dose, fever inducing Viscum album extracts and subsequent R0 resection: A case report.

作者信息

Werthmann Paul Georg, Inter Pia, Welsch Thilo, Sturm Anne-Kathrin, Grützmann Robert, Debus Markus, Sterner Martin-Günther, Kienle Gunver Sophia

机构信息

Institute for Applied Epistemology and Medical Methodology (IFAEMM) at the University of Witten/Herdecke, Freiburg i. Brsg.

Community practice for general medicine, Radebeul.

出版信息

Medicine (Baltimore). 2018 Dec;97(49):e13243. doi: 10.1097/MD.0000000000013243.

DOI:10.1097/MD.0000000000013243
PMID:30544385
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6310555/
Abstract

RATIONALE

Metastatic pancreatic cancer has a dismal prognosis. Many patients seek integrative care as an add-on to their conventional cancer treatment. Viscum album extracts (VAE)-widely used as an adjunct to cancer treatment-have cytotoxic, apoptogenic, and immune stimulatory properties. A statistically significant survival benefit has been demonstrated for VAE in advanced pancreatic cancer.

PATIENT CONCERNS AND DIAGNOSIS

A 28-year old patient presented with painless jaundice and was subsequently diagnosed as pancreatic adenocarcinoma with liver metastases.

INTERVENTIONS

He was treated with FOLFIRINOX/Mitomycin, hyperthermia and fever-inducing VAE.

OUTCOMES

Subsequently, the liver metastases regressed. Surgical intervention involved successful R0-resection of the primary tumor, as well as an atypical liver resection. A relapse was again treated with FOLFIRINOX/Mitomycin and hyperthermia. As of publication of this report, 49 months after initial diagnosis, the patient exhibits good condition, and is unrestricted in quality of life (till publication).

LESSONS

This case demonstrates the favorable outcome of a patient with metastatic pancreatic cancer following treatment with chemotherapy, integrative medicine, and surgical excision. As other positive outcomes in pancreatic cancer patients are related to inflammatory events, we presume the immunologic effects of VAE to have contributed to the favorable outcome here. Based on this case, and the other positive results of VAE use in pancreatic cancer, further investigations seem highly worthwhile.

摘要

理论依据

转移性胰腺癌预后不佳。许多患者寻求综合治疗作为其传统癌症治疗的补充。欧洲白蜡树提取物(VAE)——广泛用作癌症治疗的辅助药物——具有细胞毒性、诱导凋亡和免疫刺激特性。在晚期胰腺癌中,VAE已显示出具有统计学意义的生存获益。

患者情况与诊断

一名28岁患者出现无痛性黄疸,随后被诊断为伴有肝转移的胰腺腺癌。

干预措施

他接受了FOLFIRINOX/丝裂霉素、热疗以及诱导发热的VAE治疗。

结果

随后,肝转移灶消退。手术干预成功实现了原发肿瘤的R0切除以及非典型肝切除。复发时再次接受FOLFIRINOX/丝裂霉素和热疗。截至本报告发表时,初次诊断后49个月,患者状况良好,生活质量不受限(截至发表时)。

经验教训

本病例显示了一名转移性胰腺癌患者在接受化疗、综合医学治疗和手术切除后的良好结局。由于胰腺癌患者的其他积极结果与炎症事件有关,我们推测VAE的免疫作用促成了此处的良好结局。基于本病例以及VAE在胰腺癌中使用的其他积极结果,进一步的研究似乎非常值得。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/39be68629b8c/medi-97-e13243-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/e8360d1752bc/medi-97-e13243-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/37e52db78aa4/medi-97-e13243-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/2a259fb570e1/medi-97-e13243-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/7e0eea07d51a/medi-97-e13243-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/39be68629b8c/medi-97-e13243-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/e8360d1752bc/medi-97-e13243-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/37e52db78aa4/medi-97-e13243-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/2a259fb570e1/medi-97-e13243-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/7e0eea07d51a/medi-97-e13243-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56a/6310555/39be68629b8c/medi-97-e13243-g005.jpg

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