Liu Xiaolong, Yang Feimin, Jia Dunmao, Dong Xinyu, Zhang Yizhuo, Wu Zhengrong
Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Nursing, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Genet. 2023 Apr 20;14:1167470. doi: 10.3389/fgene.2023.1167470. eCollection 2023.
Pancreatic cancer is one of the most deadly malignancies in the world. It is characterized by rapid progression and a very poor prognosis. The five-year survival rate of pancreatic cancer in China is only 7.2%, which is the lowest among all cancers and the use of combined paclitaxel albumin, capecitabine, and digital has been the clinical standard treatment for advanced pancreatic cancer since 1997. Also, the application of multidrug combinations is often limited by the toxicity of chemotherapy. Therefore, there is an urgent need for a more appropriate and less toxic treatment modality for pancreatic cancer. The patient was a 79-year-old woman, admitted to the hospital with a diagnosis of unresectable locally advanced pancreatic cancer (T3N0M0, stage IIA), with its imaging showing overgrowth of SMV involvement and unresectable reconstruction of the posterior vein after evaluation. As the patient refused chemotherapy, lenvatinib (8 mg/time, qd) and icaritin soft capsules (three tablets/time, bid) were recommended according to our past experience and a few clinical research cases. The tumor lesion was greatly reduced by 57.5% after the treatment, and the extent of vascular involvement also decreased. The aforementioned medication resulted in a significant downstaging of the patient's tumor. Better results were achieved in the treatment with icaritin soft capsules and lenvatinib in this case. Because of its less toxic effect on the liver and kidney and bone marrow suppression, it was suitable to combine icaritin soft capsules with targeted drugs for treating intermediate and advanced malignancies, which brings hope to patients who cannot or refuse to take chemotherapy.
胰腺癌是全球最致命的恶性肿瘤之一。其特点是进展迅速，预后极差。中国胰腺癌的五年生存率仅为7.2%，是所有癌症中最低的。自1997年以来，联合使用白蛋白紫杉醇、卡培他滨和替吉奥一直是晚期胰腺癌的临床标准治疗方案。此外，多药联合应用常常受到化疗毒性的限制。因此，迫切需要一种更合适、毒性更小的胰腺癌治疗方式。该患者为一名79岁女性，因诊断为不可切除的局部晚期胰腺癌（T3N0M0，IIA期）入院，经评估其影像学显示肠系膜上静脉受累增生且后静脉不可切除重建。由于患者拒绝化疗，根据我们过去的经验和一些临床研究病例，推荐使用仑伐替尼（8毫克/次，每日一次）和淫羊藿苷软胶囊（3片/次，每日两次）。治疗后肿瘤病灶大幅缩小57.5%，血管受累程度也有所降低。上述用药使患者肿瘤明显降期。在该病例中，淫羊藿苷软胶囊与仑伐替尼联合治疗取得了更好的效果。因其对肝肾及骨髓抑制的毒性作用较小，适合将淫羊藿苷软胶囊与靶向药物联合用于治疗中晚期恶性肿瘤，这为无法或拒绝接受化疗的患者带来了希望。
