進行膵癌に対する Gemcitabine, Oxaliplatin 併用療法(GemOx)の経験 [in Japanese] Experience of gemcitabine combined with oxaliplatin (GemOx) for matastatic pancreatic adenocarcinoma [in Japanese]
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本例は, 手術中に肝転移が判明した進行膵癌症例である. 肝転移巣をマイクロ波で可及的に焼灼した後, 原発巣に20Gyの術中照射を行い, 以後, 新規抗癌剤 (Gemcitabine, Oxaliplatin ; 以下GemOx) を中心とする外来化学療法を施行した. 計10回の投与で (OX総投与量1,000mg), 末梢神経障害の増悪により中止を余儀なくされたが, 重篤な骨髄抑制・肝腎障害・ADLの低下はなく, 外来で継続投与が可能であった. GemOxの効果と副作用を考える上で, 本例が参考になればと願い報告を行った.
A 51-year-old man was admitted to our hospital for treatment of advanced pancreatic carcinoma. During surgery, several small liver metastases were discovered, and intraoperative electron beam irradiation (20 Gy) was performed for the main tumor with microwave coagulation carried out for the metastatatic sites. Postoperatively, the patient received gemcitabine 800 mg as a 10 mg/m<sup>2</sup>/min infusion followed by oxaliplatin 100 mg as a 1-hour infusion every 2 weeks. As the incidence of neurosensory disorders such as paresthesia of the lip or extremities increased with the number of courses administered, the gemcitabine-oxaliplatin regimen (GemOx) had to be stopped after ten courses. Neither nephrotoxicity nor hematologic toxicity was observed. The outpatient GemOx regimen was well tolerated by the patient. We believe that this case report demonstrates both the potential efficacy and side effects of GemOx for treatment of pancreatic carcinoma.
Suizo 20(6), 554-559, 2005-12-29
Japan Pancreas Society