A case of long survival in advanced pancreatic cancer with multiple liver metastases successfully treated by combined chemotherapy of S-1 and gemcitabine

• Published in: Suizo Vol. 23; no. 4; pp. 510 - 518
• Main Authors: ISHIGAMI, Shun-ichi, BABA, Nobuo, KITAGUCHI, Kazuhiko, SAKIKUBO, Morito, KAMIMURA, Ryou, URA, Katsuaki, OOE, Hideaki, YOSHIKAWA, Akira, TAMURA, Jun, OGAWA, Hiroki, SAKANASHI, Shirou, SAIGA, Tatsuyoshi
• Format: Journal Article
• Language: Japanese
• Published: Japan Pancreas Society 2008
• Subjects: Advanced pancreatic cancer; Gemcitabine; Long survivor; S-1; SPan-1
• ISSN: 0913-0071; 1881-2805
• DOI: 10.2958/suizo.23.510

An 81-year-old woman underwent left mastectomy for breast cancer in March 2002, and its histological type was diagnosed as pure mucinous carcinoma. In March 2004, computed tomography and ultrasonography of the abdomen revealed a 3.0cm mass in the body of the pancreas, dilatation of the main pancreatic duct, and multiple low density areas in the liver. Tumor makers were elevated: serum CEA of 4.7ng/ml, SPan-1 of 960U/ml and DUPAN-2 of more than 1600U/ml. No lesions were observed in other organs. Systemic chemotherapy using gemcitabine(GEM) was started in May 2004, and continued for day 1 every two weeks. Since serum SPan-1 showed re-elevation and the liver metastases were growing, combined chemotherapy of S-1 and GEM was started in February 2006, and serum SPan-1 normalized again. Needle biopsy of the liver tumor was performed at the time of radio-frequency ablation (RFA), and its histological type was diagnosed as metastatic adenocarcinoma. The patient died of hepatic insufficiency in January 2008, 3 years and 7 months after the initial chemotherapy. Until September 2007, 4 months before death, she lived a successful daily life without anorexia or pain. Finally,the main tumor of the pancreas shrinked to 1cm diameter. Combined chemotherapy of S-1 and GEM was useful for poor-prognostic, advanced pancreatic cancer. A synergistic effect between S-1 and GEM was speculated to exist.