Successful management for unresectable pancreatic cancer with chronic liver failure treated by gemcitabine and hemodialysis

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  • YOSHIDA Masahiro
    Department of Hemodialysis and Surgery, Chemotherapy Research Institute, Kaken Hospital
  • UKAJI Minoru
    Department of Gastroenterology, Chemotherapy Research Institute, Kaken Hospital
  • SAISHO Hiromitsu
    Department of Gastroenterology, Chemotherapy Research Institute, Kaken Hospital

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Other Title
  • 維持透析患者に発症した進行膵癌にゲムシタビン単独化学療法を施行した1例

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Description

A 69-year-old male with chronic renal failure, due to diabetic nephropathy, had received maintenance dialysis (twice/week) since July 2008. Multiple liver tumors were seen in routine abdominal ultrasound, and diagnosed as carcinoma of tail of pancreas with multiple liver metastases on CT. The patient was admitted to the Gastroenterology unit of our hospital in April 2009, and single GEM chemotherapy was started together with hemodialysis. Gemcitabine (1000mg/m2×3 times/month) was given on Monday evening, and hemodialysis was performed on Tuesday and Saturday to remove gemcitabine metabolites. Extension of dosage interval, dosage adjustment, and drug withdrawal were required due to pancytopenia and fever occurring after the administration of gemcitabine. Furthermore, blood transfusion and percutaneous transluminal angioplasty (PTA) were given for shunt failure due to severe anemia and low blood pressure. One and a half months after treatment, CT showed stable disease (SD) and also there was reduction in serum CA19-9, the patient was discharged from hospital and continued treatment as outpatient follow-up till June 2010, when the patient expired. Although there is continued hemodialysis in patients due to an increase in aging populations and lifestyle related diseases, reports on antineoplastic agents are still very rare.<br>

Journal

  • Suizo

    Suizo 27 (2), 199-205, 2012

    Japan Pancreas Society

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