Combination chemotherapy with gemcitabine and nab-paclitaxel for a metastatic pancreatic ductal adenocarcinoma patient undergoing hemodialysis
Combination chemotherapy with gemcitabine and nab-paclitaxel for a metastatic pancreatic ductal adenocarcinoma patient undergoing hemodialysis
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吉西他滨和白蛋白结合型紫杉醇联合化疗治疗接受血液透析的转移性胰腺导管腺癌患者
DOI：
10.1007/s12328-019-00976-w
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发表时间：
2019
影响因子：
1
通讯作者：
Maeda Shin
中科院分区：
文献类型：
--
作者：
Kaneko Takashi;Sugimori Kazuya;Tozuka Yuichiro;Fukushima Taito;Okada Kazuya;Oka Hiroyuki;Okazaki Hiroshi;Maeda Shin
在癌症患者中，肾功能受损并不罕见。最近，已经报道了吉西他滨和白蛋白结合型紫杉醇的组合对于胰腺导管腺癌（PDAC）患者的功效，然而，没有对经历血液透析（HD）的患者的剂量和施用的推荐。1例66岁男性4年前开始接受HD治疗慢性肾衰竭。他患有腹泻、背痛和食欲不振，体重逐渐下降。腹部动态电脑断层显示一个45毫米的低密度肿块在胰腺体和一个30毫米的低密度肿块在肝脏。患者被诊断为转移性PDAC。他开始吉西他滨和白蛋白结合型紫杉醇的联合化疗，未调整剂量。他在第一和第二个疗程中出现肺炎和中性粒细胞减少症，因此我们改为每2周第1天使用60%剂量的吉西他滨和白蛋白结合型紫杉醇。剂量调整后，他继续联合化疗超过7个月，没有严重的不良事件或肿瘤进展。使用吉西他滨和白蛋白结合型紫杉醇的联合化疗对接受HD的PDAC患者有效。虽然最初可以在不调整剂量的情况下给予这些药物，但由于严重的不良事件，我们的患者需要早期调整剂量。
In cancer patients, impairment of kidney function is not uncommon. Recently, the efficacy of the combination of gemcitabine and nab-paclitaxel for pancreatic ductal adenocarcinoma (PDAC) patients has been reported, however, there is no recommendation for dose and administration to patients undergoing hemodialysis (HD). A 66-year-old man began receiving HD for chronic renal failure 4 years previously. He suffered from diarrhea, back pain, and loss of appetite, and his weight gradually decreased. Abdominal dynamic computed tomography showed a 45-mm hypodense mass in the pancreatic body and a 30-mm hypodense mass in the liver. The patient was diagnosed with metastatic PDAC. He started combination chemotherapy of gemcitabine and nab-paclitaxel without dose modification. He developed pneumonia and neutropenia in the first and second courses, so we modified to a 60% dose of gemcitabine and nab-paclitaxel on day 1 every 2 weeks. After dose modification, he continued combination chemotherapy for over 7 months without severe adverse events or tumor progression. Combination chemotherapy using gemcitabine and nab-paclitaxel was effective in a PDAC patient undergoing HD. While it is possible to originally administer these drugs with no dose modification, early dose modification was needed for our patient because of severe adverse events.