Ozaki Kentaro, Hayashi Hiromitsu, Ikuta Yoshiaki, Masuda Toshiro, Akaboshi Shinichi, Ogata Kenichi, Matumoto Katsutaka, Ogawa Katsuhiro, Kamio Takihiro, Baba Hideo, Takamori Hiroshi
Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Kumamoto, 861-4193, Japan.
Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan.
Clin J Gastroenterol. 2019 Dec;12(6):603-608. doi: 10.1007/s12328-019-00965-z. Epub 2019 Apr 15.
FOLFIRINOX is a highly effective anticancer treatment, even in advanced pancreatic cancer, which provides a potential cure in patients initially treated with a palliative strategy. A 47-year-old man was found to have an unresectable pancreatic cancer (4 cm in size) surrounding both the superior mesenteric artery and superior mesenteric vein. A simultaneous liver metastasis in Segment 8, with a diameter of 17 mm, was also detected. The pancreatic tumor markers CEA, CA19-9, and DUPAN-2 were significantly elevated to 21.7 ng/mL, 6224 ng/mL, and 1200U/mL, respectively. After 21 courses of FOLFIRINOX, the primary pancreatic tumor diminished in size (partial response) from 42 to 17 mm, and the liver mass almost disappeared. The tumor markers significantly decreased to almost normal levels. Fourteen months after the initial chemotherapy, conversion surgery was performed. Upon surgical resection, the pancreatic tumor was found to be Grade 1b, and a pathologically complete response was observed for the liver metastasis. The patient is still alive 32 months after initial treatment with no recurrence. This is an informative case of a locally advanced pancreatic cancer with a synchronous liver metastasis that had a significant response to FOLFIRINOX, allowing for subsequent curative resection.
FOLFIRINOX是一种高效的抗癌治疗方法，即使对于晚期胰腺癌也是如此，它为最初采用姑息治疗策略的患者提供了潜在的治愈机会。一名47岁男性被发现患有不可切除的胰腺癌（大小为4厘米），包绕肠系膜上动脉和肠系膜上静脉。同时还检测到肝S8段有一个直径为17毫米的转移灶。胰腺癌肿瘤标志物癌胚抗原（CEA）、糖类抗原19-9（CA19-9）和胰腺癌相关抗原-2（DUPAN-2）分别显著升高至21.7纳克/毫升、6224纳克/毫升和1200单位/毫升。经过21个疗程的FOLFIRINOX治疗后，胰腺原发肿瘤大小从42毫米缩小至17毫米（部分缓解），肝脏肿块几乎消失。肿瘤标志物显著下降至几乎正常水平。初始化疗14个月后进行了转化手术。手术切除时，发现胰腺肿瘤为1b级，肝转移灶出现病理完全缓解。该患者在初始治疗后32个月仍然存活，无复发。这是一例局部晚期胰腺癌伴同时性肝转移对FOLFIRINOX有显著反应并允许随后进行根治性切除的病例，具有参考价值。
