内容紹介
Summary
An 80-year-old woman was diagnosed with pancreatic head cancer, and pancreaticoduodenectomy was performed. Twelve months after the operation, chest CT scans showed the presence of multiple nodules in both the lungs. Because of the potential negative side effects of anti-cancer drugs, the patient underwent chemotherapy with dose-down biweekly administration of gemcitabine(1,000 mg/day/body≒750 mg/m2. Chest CT examination every 2-3 months revealed no rapid increase in multiple tumors. Nineteen months after starting gemcitabine therapy, there was an elevation in tumor marker and a gradual increase in lung metastases. We performed combination chemotherapy with nab-paclitaxel. However, owing to side effects, only 2 courses of nab-paclitaxel were administered, and the therapy was switched to only gemcitabine administration. Later, respiratory distress accompanied by pleural effusion developed, and the patient died of the original disease 27 months after recurrence. Here, we report a case of an elderly patient with multiple lung metastases of pancreatic cancer in whom lung metastases were controlled by biweekly dose-down administration of gemcitabine.
要旨
症例は80歳,女性。膵頭部癌に対する膵頭十二指腸切除術の術後12か月目に胸部CTで膵癌多発肺転移と診断された。患者本人の副作用に対する不安が強いことから話し合った上で,gemcitabine(GEM)単独療法を減量(1,000 mg/day/body≒750 mg/m2)かつ隔週投与で開始した。2～3か月ごとの治療効果判定では腫瘍の急速な増大を認めることはなかったが,GEM開始19か月後に腫瘍マーカーの上昇および肺転移の緩徐な増大を認めた。nab-paclitaxelを2コースのみ併用したが,副作用のためGEM単独投与に変更した。その後,再発25か月目に胸水貯留に伴う呼吸苦が出現し,27か月目に原疾患にて死亡した。高齢者の膵癌術後多発肺転移に対してGEMの隔週減量投与で,良好なQOLを保ったまま転移巣をコントロールできた1例を経験したので報告する。
目次
An 80-year-old woman was diagnosed with pancreatic head cancer, and pancreaticoduodenectomy was performed. Twelve months after the operation, chest CT scans showed the presence of multiple nodules in both the lungs. Because of the potential negative side effects of anti-cancer drugs, the patient underwent chemotherapy with dose-down biweekly administration of gemcitabine(1,000 mg/day/body≒750 mg/m2. Chest CT examination every 2-3 months revealed no rapid increase in multiple tumors. Nineteen months after starting gemcitabine therapy, there was an elevation in tumor marker and a gradual increase in lung metastases. We performed combination chemotherapy with nab-paclitaxel. However, owing to side effects, only 2 courses of nab-paclitaxel were administered, and the therapy was switched to only gemcitabine administration. Later, respiratory distress accompanied by pleural effusion developed, and the patient died of the original disease 27 months after recurrence. Here, we report a case of an elderly patient with multiple lung metastases of pancreatic cancer in whom lung metastases were controlled by biweekly dose-down administration of gemcitabine.
要旨
症例は80歳,女性。膵頭部癌に対する膵頭十二指腸切除術の術後12か月目に胸部CTで膵癌多発肺転移と診断された。患者本人の副作用に対する不安が強いことから話し合った上で,gemcitabine(GEM)単独療法を減量(1,000 mg/day/body≒750 mg/m2)かつ隔週投与で開始した。2～3か月ごとの治療効果判定では腫瘍の急速な増大を認めることはなかったが,GEM開始19か月後に腫瘍マーカーの上昇および肺転移の緩徐な増大を認めた。nab-paclitaxelを2コースのみ併用したが,副作用のためGEM単独投与に変更した。その後,再発25か月目に胸水貯留に伴う呼吸苦が出現し,27か月目に原疾患にて死亡した。高齢者の膵癌術後多発肺転移に対してGEMの隔週減量投与で,良好なQOLを保ったまま転移巣をコントロールできた1例を経験したので報告する。