内容紹介
Summary
A 66-year-old man was admitted to undergo investigation for body weight loss. He was diagnosed with pancreatic neuroendocrine carcinoma, and a pancreaticoduodenectomy was performed. Three months after surgery, multiple recurrent liver metastases were observed on CT. We administered the cisplatin(CDDP)/irinotecan(CPT-11)regimen, but decided to discontinue the regimen because of adverse events. One month later, administration of everolimus(10 mg/day)was initiated. Lesion loss was observed after 8 months, and the patient achieved a complete response(CR)without abnormal accumulation of FDG on PET-CT. Administration of everolimus was discontinued after 13 months because of peripheral neuropathy. Despite drug withdrawal, the patient has remained in remission for more than 3 years. Everolimus is considered an effective treatment for MANEC from NEC.
要旨
症例は66歳,男性。体重減少を主訴に来院し,膵頭部神経内分泌癌の診断で亜全胃温存膵頭十二指腸切除術を施行した。術後3か月後のCTで多発肝転移再発を認めた。cisplatin(CDDP)/irinotecan(CPT-11)療法を行ったが,有害事象が強く継続が困難と判断し中止した。その後everolimus 10 mg/日の内服投与を開始した。8か月後には病巣の消失を認め,PET-CTでもFDGの異常集積を認めず完全奏効(CR)と判断した。13か月後に末梢神経障害のためeverolimusの投与を中止した。中止後より3年経過しているが再発を認めずCRを維持している。NECを主成分とするMANECに対する化学療法としてeverolimusは有効な治療選択肢と考えられる。
目次
A 66-year-old man was admitted to undergo investigation for body weight loss. He was diagnosed with pancreatic neuroendocrine carcinoma, and a pancreaticoduodenectomy was performed. Three months after surgery, multiple recurrent liver metastases were observed on CT. We administered the cisplatin(CDDP)/irinotecan(CPT-11)regimen, but decided to discontinue the regimen because of adverse events. One month later, administration of everolimus(10 mg/day)was initiated. Lesion loss was observed after 8 months, and the patient achieved a complete response(CR)without abnormal accumulation of FDG on PET-CT. Administration of everolimus was discontinued after 13 months because of peripheral neuropathy. Despite drug withdrawal, the patient has remained in remission for more than 3 years. Everolimus is considered an effective treatment for MANEC from NEC.
要旨
症例は66歳,男性。体重減少を主訴に来院し,膵頭部神経内分泌癌の診断で亜全胃温存膵頭十二指腸切除術を施行した。術後3か月後のCTで多発肝転移再発を認めた。cisplatin(CDDP)/irinotecan(CPT-11)療法を行ったが,有害事象が強く継続が困難と判断し中止した。その後everolimus 10 mg/日の内服投与を開始した。8か月後には病巣の消失を認め,PET-CTでもFDGの異常集積を認めず完全奏効(CR)と判断した。13か月後に末梢神経障害のためeverolimusの投与を中止した。中止後より3年経過しているが再発を認めずCRを維持している。NECを主成分とするMANECに対する化学療法としてeverolimusは有効な治療選択肢と考えられる。