[1例胰腺癌伴腹膜转移长期化疗后行转化手术的病例]
[A Case of Conversion Surgery after Long-Term Chemotherapy for Pancreatic Cancer with Peritoneal Metastasis].
作者信息
Enoki Michihiro, Gotoh Kunihito, Sakai Kenji, Toshiyama Reishi, Yanagisawa Kiminori, Kawai Kenji, Miyo Masaaki, Takahashi Yusuke, Hamakawa Takuya, Doi Takashi, Takeno Atsushi, Katoh Takeshi, Takami Koji, Hirao Motohiro
机构信息
Dept. of Surgery, National Hospital Organization Osaka National Hospital.
出版信息
Gan To Kagaku Ryoho. 2023 Jan;50(1):87-89.
A 66-year-old woman was referred to the gastroenterology division of our hospital due to elevation of serum CEA level. Contrast-enhanced CT showed a hypovascular tumor at the body of pancreas. She was diagnosed with pancreatic cancer by EUS-FNA. By laparotomy, we found white nodules on mesentery and abdominal wall, which were diagnosed as peritoneal metastasis. After systemic chemotherapy with 9 courses of gemcitabine(GEM)plus nab-paclitaxel(PTX)and 30 courses of mFOLFIRINOX, the tumor had shrunk and serum CA19-9 level were remarkably decreased. Distal pancreatectomy was performed as conversion surgery. Pathological analysis revealed no remnant cancer cells in the primary tumor or the lymph nodes, confirming a pCR. S-1 was started as adjuvant chemotherapy, and she remains alive without recurrence 8 months after surgery.
一名66岁女性因血清癌胚抗原（CEA）水平升高被转诊至我院胃肠病科。增强CT显示胰腺体部有一个低血供肿瘤。通过超声内镜引导下细针穿刺抽吸活检（EUS-FNA）诊断为胰腺癌。通过剖腹手术，我们在肠系膜和腹壁发现白色结节，诊断为腹膜转移。在接受9个疗程的吉西他滨（GEM）联合纳米白蛋白结合型紫杉醇（PTX）全身化疗以及30个疗程的改良FOLFIRINOX方案化疗后，肿瘤缩小，血清糖类抗原19-9（CA19-9）水平显著下降。作为挽救性手术进行了远端胰腺切除术。病理分析显示原发肿瘤和淋巴结中无残留癌细胞，证实达到病理完全缓解（pCR）。开始使用替吉奥（S-1）进行辅助化疗，术后8个月她仍存活且无复发。
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