Takeda Yutaka, Ohmura Yoshiaki, Katsura Yoshiteru, Sakamoto Takuya, Haruna Kengo, Kawai Kenji, Murakami Kohei, Yanagawa Takehiro, Yanai Ayako, Kagawa Yoshinori, Masuzawa Toru, Takeno Atsushi, Egawa Chiyomi, Hata Taishi, Murata Kohei
Dept. of Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2357-2359.
We report a case of liver metastases of ampullary carcinoma that achieved clinical complete response after gemcitabine plus cisplatin(GC)combination chemotherapy. A 69-year-old man with obstructive jaundice was diagnosed with ampullary carcinoma and underwent laparoscopic pancreaticoduodenectomy. Postoperative histopathological examination revealed pT3aN0M0, Stage ⅡA adenocarcinoma of the papilla of Vater. Five months after surgery, multiple liver metastases were identified by CT and MRI. The patient received GC chemotherapy intravenously at doses of 1,000 and 25mg/m2 on days 1 and 8, respectively, every 3 weeks. After 3 courses of GC chemotherapy, a CT scan revealed that the liver metastases reduced in size, and PR was achieved based on the RECIST standard. However, Grade 3 neutropenia appeared. After 7 courses, the liver metastases disappeared, and the patient had achieved CR. After 9 courses, the clinical CR continued. Approximately 14 months have passed since the recurrence, and the patient is currently alive.
我们报告1例壶腹癌肝转移患者，其在接受吉西他滨联合顺铂（GC）化疗后达到临床完全缓解。一名69岁的男性因梗阻性黄疸被诊断为壶腹癌，并接受了腹腔镜胰十二指肠切除术。术后组织病理学检查显示为pT3aN0M0，ⅡA期 Vater 乳头腺癌。术后5个月，通过CT和MRI发现多发肝转移。患者接受GC化疗，静脉给药剂量分别为第1天1000mg/m²和第8天25mg/m²，每3周重复1次。3个疗程的GC化疗后，CT扫描显示肝转移灶缩小，根据RECIST标准达到部分缓解（PR）。然而，出现了3级中性粒细胞减少。7个疗程后，肝转移灶消失，患者达到完全缓解（CR）。9个疗程后，临床CR持续存在。自复发以来已过去约14个月，患者目前仍然存活。
