Neoadjuvant Proton Beam Chemoradiotherapy for Locally Advanced Gall Bladder Cancer-A Case Report

A 67-year-old man visited our hospital due to progressing appetite loss and fever. He presented with a fist-sized palpable mass in his right hypochondrium. Abdominal CT showed a 10 cm diameter tumor that originated from the gall bladder infiltrating the abdominal wall, liver, duodenum, and colon. Bl...

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Bibliographic Details
Published inGan to kagaku ryoho Vol. 46; no. 13; p. 1975
Main Authors Ishida, Makoto, Ohno, Noriyuki, Sato, Hirohide, Kitajima, Tatsumi, Deguchi, Masaaki, Bou, Sayuri, Sato, Yoshitaka, Tamamura, Hiroyasu, Kaizaki, Yasuharu
Format Journal Article
LanguageJapanese
Published Japan 01.12.2019
Subjects
Aged
Chemoradiotherapy
Gallbladder Neoplasms - therapy
Humans
Male
Neoadjuvant Therapy
Neoplasm Recurrence, Local
Protons
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Summary:A 67-year-old man visited our hospital due to progressing appetite loss and fever. He presented with a fist-sized palpable mass in his right hypochondrium. Abdominal CT showed a 10 cm diameter tumor that originated from the gall bladder infiltrating the abdominal wall, liver, duodenum, and colon. Blood tests revealed leukocytosis, elevated C-reactive protein level, and severe malnutrition. FDG-PET showed markedly high uptake in the tumor and diffuse uptake in the spine. Owing to the inability of oral intake, he underwent laparoscopic gastrojejunostomy and intraoperative tumor biopsy, which demonstrated pathologically G-CSF-producing carcinoma in the gall bladder. For the rapidly progressive tumor, he underwent proton beam chemoradiotherapy as preoperative treatment. The tumor markedly shrunk with dramatic improvement of his inflammatory and nutritional status. Consequently, R0 resection could be performed by combination surgeries of right hemi-colectomy, pancreatoduodenectomy, and partial liver resection. He received adjuvant chemotherapy and was alive without recurrence 12 months after tumor resection. To our knowledge, this is the first report of the use of neoadjuvant proton beam chemoradiotherapy in biliary cancer.
ISSN:0385-0684