Long-term surviver with multiple lung metastases after pancreatectomy treated by continuous administration of gemcitabine hydrochloride

Abstract

The patient was a 62-year-old man with multiple lung metastases appearing thirteen months after pancreaticoduodenectomy for pancreatic head cancer. Administration of gemcitabine hydrochloride was started at a dose of 1000mg/m² with a cycle consisting of three continuous weeks of infusion followed by one week of rest. We found little toxicity to the gastrointestinal tract and finding on hematologic examination were good. Therefore, chemotherapy was carried out in an outpatient setting from the second cycle. The effect of chemotherapy was evaluated as NC (no change) by CT imaging technique after two cycles. Thus, the dose of gemcitabine was decreased to 700mg/m² from the third cycle with an aim of conserving QOL during prolonged administration. Few side effects were observed, and the chemotherapy could be continued for fourteen months in an outpatient setting without change in the disease state until the appearance of carcinomatous thoracic fluid retention. Though the prognosis of lung metastases after pancreatectomy is very poor, some patients can become long-term survivers by administration of gemcitabine, while maintaining QOL in an outpatient setting.