Neoadjuvant FOLFIRINOX for Unresectable Adenocarcinoma of the Pancreas - A Case Report
Ochiai, T.; Inoue, H.; Nakatsuji, H.; Watanabe, N.; Yoshiyama, A.; Ito, H.; Toma, A.; Nakamura, K.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 44(12): 1349-1351
2017
ISSN/ISBN: 0385-0684 PMID: 29394630 Document Number: 691519
A 38-year-old male presented to our hospital with complaint of vomiting. A CT demonstrated a mass sized 42mm in the pancreatic head invading to the duodenum and a liver mass sized 15mm in the medial segment. Biopsy revealed adenocarcinoma. Due to liver metastasis, he was deemed surgically unresectable. He was started on FOLFIRINOX therapy after gastrojejunum bypass operation. After 15 courses of the therapy, restaging showed a decrease in pancreatic tumor size and a disappearance of a liver mass along with PET-CT revealing no FDG-avid uptake. A serum value of DUPAN-2 was also normalized. He was offered resection as a potentially curative treatment. He underwent curative pancreaticoduodenectomy(PD), which was difficult to perform because of adhesion and hard fibrous tissues. Operating time and blood loss were 600 minutes and 1,933 mL, respectively. Histologic examination revealed Grade 1a histological chemotherapy effect. His cancer recurred 11 months after PD. He received nab-paclitaxel and gemcitabine regimen at out-patients clinic.