Tamura Shuta, Kimura Masashi, Tomomatsu Munefumi, Umeoka Tatsuo, Johira Hiroki, Kagajo Yasushi, Kawata Naomi, Yunoki Shigeru, Akamune Akihisa
Dept. of General Surgery, Matsuyama Shimin Hospital.
Gan To Kagaku Ryoho. 2023 Mar;50(3):333-335.
The patient was a 69-year-old man. He visited our hospital with a complaint of right back pain. An abdominal CT scan confirmed a hypovascular mass 35 mm in diameter in the pancreatic head. He was diagnosed with pancreatic head cancer (cT3, cN0, cM0, cStage ⅡA, borderline resectable-A). Gemcitabine plus S-1(GS)-based chemoradiation therapy(CRT) was performed, followed by 6 courses of GS therapy. Tumor markers were almost normalized, and subtotal stomach-preserving pancreaticoduodenectomy was performed. Histopathological examination of the resected specimen revealed highly atrophic pancreatic tissue with fibrosis and no evidence of residual cancer cells (pathological complete response). The patient remains disease-free 36 months after surgery. There are few reports of pancreatic cancer with pCR after GS-based chemoradiation therapy and subsequent GS therapy. We therefore report this case together with a review of the literature.
该患者为一名69岁男性。他因右侧背痛前来我院就诊。腹部CT扫描证实胰头有一个直径35毫米的乏血供肿块。他被诊断为胰头癌(cT3,cN0,cM0,cⅡA期,可切除边缘-A)。进行了吉西他滨联合S-1(GS)的放化疗,随后进行了6个疗程的GS治疗。肿瘤标志物几乎恢复正常,遂行保留部分胃的胰十二指肠切除术。切除标本的组织病理学检查显示胰腺组织高度萎缩伴纤维化,未发现残留癌细胞的证据(病理完全缓解)。患者术后36个月无疾病复发。关于基于GS的放化疗及后续GS治疗后胰腺癌出现病理完全缓解的报道很少。因此,我们报告该病例并对文献进行综述。