• 대한암한의학회지
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• 제26권1호
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• pp.39-48
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• 2021

Objective: The purpose of this study is to report effects and potential of Integrative Cancer Treatment (ICT) on metastatic pancreatic cancer patient. Methods: A 79-year-old pancreatic cancer patient diagnosed with metastasis on liver visited the Daejeon Korean medicine hospital of Daejeon university East West Cancer Center (EWCC) on May 2021. The patient has been received chemotherapy (gemcitabine plus abraxane) and concurrently treated with ICT since May 2021. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (CEA, CA19-9) and numeric rating scales (NRS). Laboratory analysis and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0 were used to evaluate the safety of ICT. Results: After treatment, constipation was relieved from NRS 5-6 to 2, both leg numbness was improved from NRS 9 to 2. Tumor size was generally decreased accompanying by reducing the levels of tumor markers. There were no severe adverse events induced by ICT based on NCI CTCAE version 5.0. Conclusion: This case study suggests that ICT in combination with chemotherapy may help in the treatment of patients with metastatic pancreatic cancer.

• Journal of Digestive Cancer Research
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• 제6권2호
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• pp.73-77
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• 2018

췌장암으로 진단된 70세 여자 환자가 유문보존 췌십이지장 절제술 및 5-fluorouracil 동시항암화학요법으로 치료받았다. 수술 후 병리학적으로 pT3N0 (stage IIA)의 췌장선암이 확진되었다. 14개월 뒤 복부 전산화단층촬영에서 10 mm 크기의 단일 간 재발 병소가 간 3번 분엽에서 발견되었다. Gemcitabine 12주기 및 capecitabine plus oxaliplatin 9주기 항암치료를 시행했으나 전이병소는 27mm로 크기가 증가하였다. 이에 간 3번 분엽의 종양절제술을 시행하였다. 종양절제술 시행 25개월 뒤 흉부 전산화단층촬영에서 23 mm 크기의 단일 공동성 폐결절이 발견되었고, 조직검사에서 전이성 선암으로 확인되었다. 환자는 두 차례의 정위적 체부 방사선 치료 후 질병의 진행 없이 진단 후 6년 이상 장기 생존 중이다. 본 증례를 통해 수술 후 단일 간 전이 혹은 폐 전이가 발견된 일부 환자들에서 수술적 절제를 비롯한 국소 치료가 장기생존에 도움이 될 것으로 사료된다.

• Journal of Digestive Cancer Research
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• 제2권2호
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• pp.72-74
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• 2014

췌장암은 예후가 매우 불량한 대표적인 암이며, 특히 전이성 췌장암의 경우 생존기간이 3-6개월에 불과하다. 대부분의 췌장암 치료는 항암화학요법이 근간을 이루지만 수술적 치료 이외에 항암화학요법이나 방사선 치료에는 반응이 미미한 것으로 알려져 있다. 저자들은 다발성 혈관 침범과 복강 내 림프절 전이를 보이는 수술이 불가능한 진행성 췌장암에서 젬시타빈 단독 항암화학요법과 고식적 방사선 치료, 그리고 병행한 사이버나이프 추가 치료로 7년 이상의 장기 생존을 보인 증례를 경험하였다. 추적관찰 중 한 차례의 재발과 병발한 원발성 폐암이 확인되었으나, 이 역시 사이버나이프 치료 후 완전 관해를 보인 드문 증례기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.124-132
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• 2022

Background: Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer. Methods: We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020. Results: Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57-62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5-8.6 months) and 4.5 months (95% CI, 2.7-6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS. Conclusion: The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

• Journal of Digestive Cancer Research
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• 제4권2호
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• pp.127-129
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• 2016

The prognosis for pancreatic cancer patient is very poor. Patients with locally advanced disease have a median survival time of 8 to 12 months, and patients with distant metastases have significantly worse outcomes, with a median survival time of only 3 to 6 months. Approximately 30% of patients with pancreatic cancer present with locally advanced disease defined as unresectable pancreatic cancer without evidence of distant metastatic disease. Primary treatment options in locally advanced pancreatic cancer include chemotherapy and radiotherapy. Here, we reported a patient with locally advanced pancreatic cancer who does not want further chemotherapy because of chemotherapy induced nausea and vomiting. Irreversible electroporation was performed. Irreversible electroporation was well tolerated in this case, and may be a therapeutic modality for selected patients with locally advanced pancreatic cancer.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.428.1-428.1
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• 2002

Gemcitabine demonstrated modest activity in locally advanced and metastatic pancreatic cancer with difficulty early diagnosis and poor prognisis. The purpose of this study was to evaluate the efficacy and toxicity of gemcitabine and 5-fluorouracil(GF) combination theraphy and epirubicin. cisplatin. and 5-fluorouracil(ECF) combination theraphy for the patients with locally advanced or metaststic pancreatic cancer. Between January 1996 and December 2001. (omitted)

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.62-65
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• 2017

2013년 실제 임상에 Gemcitabine과 nab-paclitaxel 병용요법이 적용된 후 NCCN Guideline에서 절제 불가능한 췌장암 환자에서 일차적으로 선택할 수 있는 약제로 제시하고 있다. 이 병용요법으로 인한 가장 흔한 Grade 3 부작용으로는 호중구감소증, 피로, 말초신경병증이 보고되었으며, 심장독성은 흔하지 않다. 본 증례에서는 심장표지자의 상승 및 심초음파에서의 우측관상동맥의 허혈 손상이 확인되어 병용요법으로 인한 심장 허혈 손상 및 심낭삼출물이 발생하여, 심장성 쇼크로 사망하였을 것으로 추정해 볼 수 있다. Gemcitabine과 nab-paclitaxel에 의한 심장 허혈 손상의 더 많은 증례 보고 및 연구가 필요하며, 병용요법을 투여 받는 환자들에 대한 심장독성에 대하여 주의 깊은 관찰이 필요할 것으로 생각된다.

• 대한한방내과학회지
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• 제41권2호
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• pp.166-176
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• 2020

Objectives: This study reports on the effect of Integrative Medicine Therapy (IMT) on a patient with pancreatic cancer with liver metastasis. Methods: One pancreatic cancer with liver metastasis patient was treated using IMT in conjunction with Gemcitabine/Abraxane since September 2019. The cycle was repeated every four weeks for a total of 11 times. At the same time, the patient was treated with IMT. Tumor size was measured by scanning with Computed Tomography (CT). Adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Gemcitabine/Abraxane and IMT for eight months, the size of the body and tail of the cancer tumor and several hepatic metastatic regions decreased (partial response, [PR]), size, and number of multiple nodules in both lungs decreased. No evidence of newly developed metastatic lesions was found. The patient has maintained a good treatment outcome and has shown prolonged overall survival. Conclusions: This case demonstrates that treatment with IMT may have substantial benefits for patients with end-stage pancreatic cancer.

• Journal of Digestive Cancer Reports
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• 제7권1호
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• pp.22-25
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• 2019

췌장암은 예후가 불량한 암으로 진단 당시 진행된 상태로 수술적 치료의 적응증이 되지 못해 고식적 항암 치료를 받는 경우가 대부분이다. 진단 당시 전이성 병변을 동반한 췌장암인 경우 예후가 좋지 않을 것으로 예상하지만 고식적 목적으로 항암치료를 한 결과 매우 좋은 반응을 보였던 증례를 문헌 고찰과 함께 보고한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7119-7123
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• 2014

Background: The role of second-line therapy in metastatic pancreatic cancer is not clear. In this study, we aimed to explore the second-line efficiency of capecitabine and oxaliplatin (XELOX) in patients with advanced pancreatic cancer who have received gemcitabine-based first-line therapy. Materials and Methods: We retrospectively evaluated 47 patients with locally advanced or metastatic pancreatic cancer previously treated with gemcitabine-based first-line regimens. Treatment consisted of oxaliplatin $130mg/m^2$ and capecitabine $1000mg/m^2$ twice daily with a 3 week interval, until unacceptable toxicity or disease progression. Results: Median number of cycles was 4 (range, 2-10). The overall disease control rate was 38.3%. The median overall survival and progression-free survival from the start of second-line therapy were 23 weeks (95%CI: 16.6-29.5 weeks) and 12 weeks (95%CI: 9.8-14.4 weeks), respectively. The most common grade 3-4 toxicities were nausea, vomiting and hematologic side effects. Conclusions: Our result suggests that the combination of capecitabine and oxaliplatin was tolerated with manageable toxicity and showed encouraging activity as second-line treatment of advanced or metastatic pancreatic cancer patients with ECOG performance status 0-2.