内容紹介
Conversion Surgery for Initially Unresectable Locally Advanced Pancreatic Cancer Following Gemcitabine plus Nab-Paclitaxel―A Case Report
Summary
We report a case of unresectable locally advanced pancreatic cancer successfully resected after gemcitabine(GEM)plus nab-paclitaxel(PTX)treatment. A 68-year-old man was referred to our institution with jaundice. We diagnosed pancreatic head cancer using computed tomography(CT)and endoscopic retrograde cholangiopancreatography. We initially diagnosed it as locally advanced unresectable pancreatic cancer because of extensive invasion to the portal vein. GEM plus nab-PTX was administered to the patient as systemic chemotherapy. After 9 courses of chemotherapy, a CT scan revealed that the tumor had significantly reduced in size and range of portal vein invasion. Therefore, we performed pancreaticoduodenectomy with resection of the portal vein and achieved R0 resection. Currently, the patient is alive without recurrence. Therefore, conversion surgery after treatment with GEM plus nab-PTX chemotherapy for unresectable pancreatic cancer should be considered.
要旨
gemcitabine(GEM)+nab-paclitaxel(PTX)併用療法後に根治切除が可能となった切除不能膵癌の1例を経験したので報告する。症例は68歳,男性。黄疸を主訴に受診し,精査の結果,高度門脈浸潤を伴う局所進行切除不能膵癌と診断した。GEM+nab-PTX併用療法を9コース施行後,著明な腫瘍縮小効果を認め,切除可能と判断した。亜全胃温存膵頭十二指腸切除術,門脈合併切除術を施行しR0切除が得られた。現在,外来にて術後補助化学療法としてS-1の内服を行い,無再発生存中である。今後,切除不能膵癌に対してGEM+nab-PTXのような強力な化学療法を施行することで,切除可能となる症例が増えることが考えられる。
目次
Summary
We report a case of unresectable locally advanced pancreatic cancer successfully resected after gemcitabine(GEM)plus nab-paclitaxel(PTX)treatment. A 68-year-old man was referred to our institution with jaundice. We diagnosed pancreatic head cancer using computed tomography(CT)and endoscopic retrograde cholangiopancreatography. We initially diagnosed it as locally advanced unresectable pancreatic cancer because of extensive invasion to the portal vein. GEM plus nab-PTX was administered to the patient as systemic chemotherapy. After 9 courses of chemotherapy, a CT scan revealed that the tumor had significantly reduced in size and range of portal vein invasion. Therefore, we performed pancreaticoduodenectomy with resection of the portal vein and achieved R0 resection. Currently, the patient is alive without recurrence. Therefore, conversion surgery after treatment with GEM plus nab-PTX chemotherapy for unresectable pancreatic cancer should be considered.
要旨
gemcitabine(GEM)+nab-paclitaxel(PTX)併用療法後に根治切除が可能となった切除不能膵癌の1例を経験したので報告する。症例は68歳,男性。黄疸を主訴に受診し,精査の結果,高度門脈浸潤を伴う局所進行切除不能膵癌と診断した。GEM+nab-PTX併用療法を9コース施行後,著明な腫瘍縮小効果を認め,切除可能と判断した。亜全胃温存膵頭十二指腸切除術,門脈合併切除術を施行しR0切除が得られた。現在,外来にて術後補助化学療法としてS-1の内服を行い,無再発生存中である。今後,切除不能膵癌に対してGEM+nab-PTXのような強力な化学療法を施行することで,切除可能となる症例が増えることが考えられる。