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首页> 美国卫生研究院文献>Case Reports in Oncological Medicine >Complete Response after Treatment with Neoadjuvant Chemoradiation with Prolonged Chemotherapy for Locally Advanced Unresectable Adenocarcinoma of the Pancreas
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Complete Response after Treatment with Neoadjuvant Chemoradiation with Prolonged Chemotherapy for Locally Advanced Unresectable Adenocarcinoma of the Pancreas

机译：新辅助放化疗联合局部局部晚期不可切除的胰腺腺癌的长期化疗后的完全缓解

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Surgery is the only chance for cure in pancreatic ductal adenocarcinoma. In unresectable, locally advanced pancreatic cancer (LAPC), the National Comprehensive Cancer Network (NCCN) suggests chemotherapy and consideration for radiation in cases of unresectable LAPC. Here we present a rare case of unresectable LAPC with a complete histopathological response after chemoradiation followed by surgical resection. A 54-year-old female presented to our clinic in December 2013 with complaints of abdominal pain and 30-pound weight loss. An MRI demonstrated a mass in the pancreatic body measuring 6.2 × 3.2 cm; biopsy revealed proven ductal adenocarcinoma. Due to splenic vein/artery and contiguous celiac artery encasement, she was deemed surgically unresectable. She was started on FOLFIRINOX therapy (three cycles), intensity modulated radiation to a dose of 54 Gy in 30 fractions concurrent with capecitabine, followed by FOLFIRI, and finally XELIRI. After 8 cycles of ongoing XELIRI completed in March 2015, restaging showed a remarkable decrease in tumor size, along with PET-CT revealing no FDG-avid uptake. She was reevaluated by surgery and taken for definitive resection. Histopathological evaluation demonstrated a complete R0 resection and no residual tumor. Based on this patient and literature review, this strategy demonstrates potential efficacy of neoadjuvant chemoradiation with prolonged chemotherapy, followed by surgery, which may improve outcomes in patients deemed previously unresectable.
机译：手术是治愈胰腺导管腺癌的唯一机会。在无法切除的局部晚期胰腺癌（LAPC）中，国家综合癌症网络（NCCN）建议对无法切除的LAPC进行化疗并考虑放疗。在这里，我们介绍了一种罕见的不可切除的LAPC病例，它在放化疗后进行了手术切除后具有完整的组织病理学反应。 2013年12月，一名54岁的女性因腹痛和30磅的体重减轻而就诊于我们的诊所。核磁共振检查显示胰体肿块为6.2×3.2 cm。活检显示已证实为导管腺癌。由于脾静脉/动脉和腹腔连续动脉包裹，她被认为无法手术切除。她开始进行FOLFIRINOX疗法（三个周期），并在30倍剂量下与卡培他滨同时进行强度调制的放射至54 Gy剂量，随后是FOLFIRI，最后是XELIRI。在正在进行的XELIRI的8个周期于2015年3月完成后，重新分期显示肿瘤大小显着减少，而PET-CT显示没有FDG-avid摄取。通过手术对她进行了重新评估，并进行了明确的切除。组织病理学评估显示完全R0切除，无残留肿瘤。根据该患者和文献综述，该策略证明了长期化疗后进行新化学疗法放化疗的潜在疗效，这可能会改善以前认为无法切除的患者的预后。

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