Conversion surgery for an initially unresectable, locally advanced pancreatic cancer after induction chemotherapy and carbon-ion radiotherapy: a case report
| Autor: | Toshio Nakagohri, Kenichi Hirabayashi, Daisuke Furukawa, Yohei Kawashima, Naoki Yazawa, Takeshi Fujishiro, Taro Mashiko, Masami Ogawa, Misuzu Yamada, Yosihito Masuoka |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Locally advanced pancreatic cancer lcsh:Surgery Conversion surgery 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pancreatic cancer medicine Carbon-ion radiotherapy Chemotherapy business.industry Induction chemotherapy lcsh:RD1-811 medicine.disease Pancreaticoduodenectomy Primary tumor Gemcitabine Surgery Radiation therapy Paclitaxel chemistry 030220 oncology & carcinogenesis Gemcitabine + nab-paclitaxel 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Surgical Case Reports, Vol 4, Iss 1, Pp 1-5 (2018) |
| ISSN: | 2198-7793 |
| DOI: | 10.1186/s40792-018-0522-4 |
| Popis: | Background Pancreatic cancer has a very high mortality rate worldwide, and about 30–40% of all patients have extensive vascular involvement at initial diagnosis that precludes surgical intervention. Here, we describe our experience in a patient with locally advanced pancreatic cancer (LAPC) who underwent R0 conversion surgery after undergoing a combination of chemotherapy and carbon-ion radiotherapy (CIRT), which led to long-term relapse-free survival (23 months). Case presentation A 41-year-old woman presented a month ago with epigastralgia referred to our facility and was subsequently diagnosed with pancreatic cancer cStage III (Ph, TS2 (35 mm), cT4, cCH1, cDU1, cS1, cRP1, cPL1, cVsm0, cAsm1, cN0, cM0) that was also categorized as an unresectable LAPC. She immediately underwent 3 cycles of induction chemotherapy (gemcitabine + nanoparticle albumin-bound (nab-) paclitaxel) followed by CIRT with concurrent gemcitabine. Although significant shrinkage of the primary tumor occurred, frequent cholangitis due to duodenal stenosis of unknown etiology prevented continued chemotherapy, and 9 months after the first visit, she underwent a radical, subtotal, stomach-preserving, pancreaticoduodenectomy (SSPPD). Histopathologic examination of the resected tissue revealed a R0 resection with a histological response of Evans grade IIB. She was administered an almost full dose of S-1 as adjuvant chemotherapy for 6 months and has shown no signs of recurrence in 23 months. Conclusions We report a first case of successful conversion surgery for an initially unresectable LAPC after rapid induction GEM + nab-PTX chemotherapy followed by CIRT. Rapid induction GEM + nab-PTX chemotherapy followed by CIRT for LAPC might be a safe and effective treatment option. |
| Databáze: | OpenAIRE |
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