Blomstrand Hakon, Adolfsson Karin, Sandström Per, Björnsson Bergthor
Department of Clinical Pathology and Department of Clinical and Experimental Medicine, Linköping University, 58183 Linköping, Sweden.
Department of Oncology, Ryhov County Hospital, 55305 Jönköping, Sweden.
Case Rep Gastrointest Med. 2020 Jan 31;2020:4138215. doi: 10.1155/2020/4138215. eCollection 2020.
Pancreatic ductal adenocarcinoma (PDAC) has a bleak prognosis, especially for the majority of patients diagnosed with metastatic disease. The primary option for palliative treatment is chemotherapy, and responses beyond first-line treatment are rare and typically short. Here, we report a case of a 63-year-old woman with PDAC in the head of the pancreas who was initially successfully treated by pancreaticoduodenectomy followed by adjuvant chemotherapy with gemcitabine. However, disease recurrence with liver and para-aortic lymph node metastases was detected only two months after the completion of adjuvant chemotherapy. First-line palliative chemotherapy with gemcitabine-nab/paclitaxel was commenced. The results were discouraging, with disease progression (liver and lung metastases) detected at the first evaluation; the progression-free survival was just two months (64 days). Surprisingly, the response to second-line palliative chemotherapy with 5-fluorouracil-oxaliplatin was excellent; in combination with the ablation of a liver metastasis, this treatment regimen resulted in a complete radiological response and an 11-month treatment-free interval with a sustained good performance status.
胰腺导管腺癌（PDAC）的预后很差，尤其是对于大多数被诊断为转移性疾病的患者。姑息治疗的主要选择是化疗，一线治疗后的反应很少见，而且通常持续时间很短。在此，我们报告一例63岁女性胰腺头部PDAC患者，该患者最初通过胰十二指肠切除术成功治疗，随后接受吉西他滨辅助化疗。然而，辅助化疗完成仅两个月后就检测到疾病复发，出现肝转移和主动脉旁淋巴结转移。开始使用吉西他滨纳米白蛋白结合型紫杉醇/紫杉醇进行一线姑息化疗。结果令人沮丧，首次评估时就检测到疾病进展（肝转移和肺转移）；无进展生存期仅为两个月（64天）。令人惊讶的是，二线姑息化疗使用氟尿嘧啶-奥沙利铂的反应非常好；结合肝转移灶消融，该治疗方案导致了完全的影像学反应和11个月的无治疗间期，且患者的身体状况持续良好。
