Combined systemic and intraarterial chemotherapy with gemcitabine and concomitant external-beam radiotherapy in patients with liver metastasis from pancreatic cancer--report of two cases

摘要

We treated two patients of pancreatic tail cancer with liver metastasis combining systemic and intraarterial chemotherapy with gemcitabine and concomitant external-beam radiotherapy. Case 1: A 61-year-old man was treated with systemic chemotherapy with gemcitabine: 200 mg once a week, concurrently with external-beam radiotherapy at a dose of 39.6 Gy in 22 fractions. After radiotherapy, gemcitabine, 200 mg/body intraarterial and 1,000 mg/body systemic, was given weekly for three weeks at every 4-week interval. Despite the shrinkage of both the primary and hepatic lesions, he died from lung metastasis 10 months after beginning chemotherapy. Case 2: A 72-year-old woman was treated with arterial infusion chemotherapy with gemcitabine: 400 mg once a week, concurrently with external-beam radiotherapy at a dose of 41.4 Gy in 23 fractions. After radiotherapy, gemcitabine, 400 mg/body intraarterial and 800 mg/body systemic, was given biweekly. Despite the fact that the hepatic tumor enlarged in size, the primary site was stable and she had good quality of life one year after beginning therapy. Combined systemic and intraarterial chemotherapy with gemcitabine and concomitant external-beam radiotherapy is effective and one of the options in treatment for patients with liver metastasis from pancreatic cancer.