Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy
Pancreatic ductal adenocarcinoma (PDAC) has a bleak prognosis, especially for the majority of patients diagnosed with metastatic disease. The primary option for palliative treatment is chemotherapy, and responses beyond first-line treatment are rare and typically short. Here, we report a case of a 6...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/4138215 |
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| author | Hakon Blomstrand Karin Adolfsson Per Sandström Bergthor Björnsson |
| author_facet | Hakon Blomstrand Karin Adolfsson Per Sandström Bergthor Björnsson |
| author_sort | Hakon Blomstrand |
| collection | DOAJ |
| description | Pancreatic ductal adenocarcinoma (PDAC) has a bleak prognosis, especially for the majority of patients diagnosed with metastatic disease. The primary option for palliative treatment is chemotherapy, and responses beyond first-line treatment are rare and typically short. Here, we report a case of a 63-year-old woman with PDAC in the head of the pancreas who was initially successfully treated by pancreaticoduodenectomy followed by adjuvant chemotherapy with gemcitabine. However, disease recurrence with liver and para-aortic lymph node metastases was detected only two months after the completion of adjuvant chemotherapy. First-line palliative chemotherapy with gemcitabine-nab/paclitaxel was commenced. The results were discouraging, with disease progression (liver and lung metastases) detected at the first evaluation; the progression-free survival was just two months (64 days). Surprisingly, the response to second-line palliative chemotherapy with 5-fluorouracil-oxaliplatin was excellent; in combination with the ablation of a liver metastasis, this treatment regimen resulted in a complete radiological response and an 11-month treatment-free interval with a sustained good performance status. |
| format | Article |
| id | doaj-art-bef47b91c7784343b8d4ab1f114b81c9 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-bef47b91c7784343b8d4ab1f114b81c92025-02-03T06:06:42ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362020-01-01202010.1155/2020/41382154138215Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative ChemotherapyHakon Blomstrand0Karin Adolfsson1Per Sandström2Bergthor Björnsson3Department of Clinical Pathology and Department of Clinical and Experimental Medicine, Linköping University, 58183 Linköping, SwedenDepartment of Oncology, Ryhov County Hospital, 55305 Jönköping, SwedenDepartment of Surgery and Department of Clinical and Experimental Medicine, Linköping University, 58183 Linköping, SwedenDepartment of Surgery and Department of Clinical and Experimental Medicine, Linköping University, 58183 Linköping, SwedenPancreatic ductal adenocarcinoma (PDAC) has a bleak prognosis, especially for the majority of patients diagnosed with metastatic disease. The primary option for palliative treatment is chemotherapy, and responses beyond first-line treatment are rare and typically short. Here, we report a case of a 63-year-old woman with PDAC in the head of the pancreas who was initially successfully treated by pancreaticoduodenectomy followed by adjuvant chemotherapy with gemcitabine. However, disease recurrence with liver and para-aortic lymph node metastases was detected only two months after the completion of adjuvant chemotherapy. First-line palliative chemotherapy with gemcitabine-nab/paclitaxel was commenced. The results were discouraging, with disease progression (liver and lung metastases) detected at the first evaluation; the progression-free survival was just two months (64 days). Surprisingly, the response to second-line palliative chemotherapy with 5-fluorouracil-oxaliplatin was excellent; in combination with the ablation of a liver metastasis, this treatment regimen resulted in a complete radiological response and an 11-month treatment-free interval with a sustained good performance status.http://dx.doi.org/10.1155/2020/4138215 |
| spellingShingle | Hakon Blomstrand Karin Adolfsson Per Sandström Bergthor Björnsson Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy Case Reports in Gastrointestinal Medicine |
| title | Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy |
| title_full | Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy |
| title_fullStr | Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy |
| title_full_unstemmed | Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy |
| title_short | Complete Radiologic Response of Metastatic Pancreatic Ductal Adenocarcinoma to Microwave Ablation Combined with Second-Line Palliative Chemotherapy |
| title_sort | complete radiologic response of metastatic pancreatic ductal adenocarcinoma to microwave ablation combined with second line palliative chemotherapy |
| url | http://dx.doi.org/10.1155/2020/4138215 |
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