Acinar cell carcinoma of the pancreas successfully treated by en bloc resection and intraperitoneal chemotherapy for peritoneal relapse: a case report of a 15-year survivor.
Acinar cell carcinoma of the pancreas successfully treated by en bloc resection and intraperitoneal chemotherapy for peritoneal relapse: a case report of a 15-year survivor.
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通过整块切除和腹膜内化疗成功治疗胰腺腺泡细胞癌腹膜复发：15 年幸存者的病例报告。
作者：
S. Kobayashi;O. Ishikawa;H. Ohigashi;T. Yamada;Y. Sasaki;S. Imaoka;H. Uehara;A. Nakaizumi;A. Takenaka;T. Kasugai
腺泡细胞癌(ACC)是一种罕见的胰腺恶性肿瘤，目前尚不清楚如何最好地治疗此类肿瘤，特别是在晚期或疾病复发后。我们报告一位在成功切除局部晚期胰头癌并整块切除肝总动脉后存活15年的病例。手术九年后，她出现了大量血性腹水，其中含有许多来源于腺泡细胞的癌细胞。每两周抽吸2,000毫升腹水，并向腹膜腔内注射顺铂20 mg。在我们的门诊重复这种治疗四次后，腹水消失了，没有出现任何副作用。患者在化疗后6年仍活着，没有表现出疾病复发的迹象。这些观察表明，如果胰腺ACC能够有效地到达癌细胞，它可能对顺铂非常敏感。因此，对于腹膜种植型ACC，腹膜内注射顺铂是值得的。胰腺腺泡细胞癌是一种罕见的肿瘤，占胰腺外分泌肿瘤的1-2%(1)。据报道，Klimstra和Cubilla(2，3)的总5年生存率分别为6%和0%，而ACC的最佳治疗策略尚未确定。肝脏是胰腺癌最常见的远处转移部位。最近的一些报道表明，5-氟尿嘧啶(5-FU)和顺铂(CDDP)(4，5)联合动脉内化疗对ACC的肝转移有良好的疗效。在胰腺癌中，腹膜扩散比肝脏转移更少见，以前还没有关于这种情况的积极或成功治疗的报道。然而，我们报告一例腹膜癌在原发胰腺癌切除后发生，但经腹腔注射顺铂成功治愈。这些发现对ACC治疗的未来有重要的意义，特别是在晚期或癌症复发后。
Acinar cell carcinoma (ACC) is an uncommon malignant tumor of the pancreas and it remains unclear how best to treat such tumors, especially at an advanced stage or after disease relapse. We report a 15-year survivor after successful resection of locally advanced ACC of the pancreatic head with en bloc resection of the common hepatic artery. Nine years after surgery, she developed massive bloody ascites containing many cancer cells of acinar cell origin. A volume of 2,000 mL of ascites was aspirated and 20 mg of cisplatin was injected into the peritoneal cavity biweekly. After this treatment had been repeated four times at our outpatient clinic, the ascites disappeared without the appearance of any adverse side effects. The patient was alive 6 years after chemotherapy and had shown no signs of disease relapse. These observations suggested that pancreatic ACC may be very sensitive to cisplatin, if it can efficiently reach the cancer cells. Intraperitoneal cisplatin administration is, therefore, worth performing for treatment of the peritoneal seeding ACC. Acinar cell carcinomas of the pancreas are uncommon neoplasms, accounting for 1–2% of all cases of exocrine pancreatic tumors (1). The overall 5-year survival rate was reported to be as low as 6% by Klimstra and 0% by Cubilla (2,3), and no optimal treatment strategy for ACC has yet been determined. The liver is the most common site of distant metastasis from pancreatic ACC. Some recent reports suggested a good response rate of liver metastases of ACC to intra-arterial chemotherapy with a combination of 5-fluorouracil (5-FU) and cisplatin (CDDP) (4,5). Peritoneal spreading is less common than liver metastasis in pancreatic ACC, and there have been no previous reports of active or successful treatment for this condition. However, we report a case in which peritoneal carcinomatosis had once developed after resection of primary pancreatic ACC but it was successfully cured by an intraperitoneal administration of CDDP. These findings have important implications for the future of ACC treatment, especially at advanced stages or after cancer recurrence.
恶性腹水患者腹腔注射顺铂：药代动力学评估及与静脉注射途径的比较。
DOI：
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发表时间：
1983
期刊：
Cancer treatment reports
影响因子：
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作者：
Casper,ES;Kelsen,DP;Alcock,NW;LewisJr,JL
通讯作者：
LewisJr,JL