절제 불가능한 췌장암 환자의 술 전 화학방사선 보조요법의 의의
Preoperative Chemoradiation and Pancreaticoduodenectomy with Portal Vein Resection for Localized Advanced Pancreatic Cancer
채윤석, 김경식, 이우정, 김병로, 이종훈,
소속 상세정보
채윤석 ( Chae Yoon-Seok )
연세대학교 의과대학 외과학교실
김경식 ( Kim Kyung-Sik )
연세대학교 의과대학 외과학교실
이우정 ( Lee Woo-Jung )
연세대학교 의과대학 외과학교실
김병로 ( Kim Byong-Ro )
연세대학교 의과대학 외과학교실
이종훈 ( Lee Jong-Hoon )
연세대학교 의과대학 외과학교실
KMID : 0371320010600030349
Abstract
Purpose: Chemoradiation therapy prior to pancreaticoduodenectomy has several effects. First, it ensures that patient who undergo resection subsequently complete multimodality therapy and helps to avoid resection in patients with rapid progressive disease. Second, it allows radiation therapy to be delivered to well oxygenated cells before surgical devasculation. Finally, in such cases there is a chance of resection of unresectable pancreatic cancer by downstaging.
Methods: A patient with cytologic proof of localized adenocarcinoma of the pancreatic head recieved preoperative chemoradiation (Taxol, 50 mg/m2 IV for 3 hours weekly 3 cycles, Gemcytabine 1,000 mg/m2/day IV for 3 days weekly 2 cycles, 4,500 cGy) with the intent of proceeding to resection, Restaging was performed by computed tomography and magnetic resonance imaging every months from 5 weeks due to the ongoing decreasing of tumor size following the completion of chemoradiation. Upon laparotomy, the patient was found to not have any suspected metastatic disease and the tumor size was 2?3 cm on the pancreas head infiltrating to the portal vein approximately 3 cm in length along right side. Pancreaticoduodenectomy was performed with partial portal vein and superior mesenteric vein resection followed by reconstruction of the vascular anastomosis by using the right side internal jugular vein. Perioperative complication did not occur.
Results and Conclusion: Preoperative chemoradiation of localized advanced pancreatic has a low incidence of operative complication and enhanced resectability.
키워드
화학방사선요법;췌장암
Chemoradiation therapy;Pancreatic cancer
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