2019 Volume 34 Issue 4 Pages 172-180
A 64 year-old man noted jaundice, and was found to have pancreatic cancer, which was treated by radical resection. However, 4 months after resection, his serum CEA level was elevated and a low-density area suggesting metastatic disease was detected in the liver (S7). The patient was treated with FOLFIRINOX chemotherapy and GEM+nab-PTX combination chemotherapy. After chemotherapy, the liver (S7) metastasis was smaller, but 1 month after the tumor resection, a new recurrence was detected in the liver (S6). Treating the new liver metastasis only with chemotherapy was considered difficult, so proton radiation therapy (64Gy) was given. After the radiation therapy, chemotherapy continued for 2 years, and a complete response (CR) was achieved. At 55 months after resection, this patient is alive without new recurrent disease.