Медицинская литература. Новинки

 

 

 

 

 

 

Панкреатодуоденальная резекция при первично нерезектабельном раке головки поджелудочной железы после неоадъювантной химиотерапии

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Представлено клиническое наблюдение успешного комбинированного лечения пациента с протоковой аденокарциномой головки поджелудочной железы с распространением на верхнюю брыжеечную артерию и вену. При обследовании диагностирована нерезектабельная опухоль. После 12 курсов химиотерапии по схеме FOLFIRINOX получены хорошие результаты, план лечения был изменен и выполнена типичная панкреатодуоденальная резекция. При патоморфологическом исследовании – протоковая аденокарцинома урT1N0M0R0, II степень терапевтического патоморфоза (TRG 2). Послеоперационный период без осложнений. Эффективность лекарственного лечения при протоковой аденокарциноме в последние годы заметно возросла. Неоадъювантную химиотерапию можно считать наиболее эффективной при местном распространении опухоли.

Ключевые слова:
поджелудочная железа, панкреатодуоденальная резекция, местно-распространенный рак, протоковая аденокарцинома, полный патоморфоз

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Pancreaticoduodenal resection for primary unresectable pancreatic head cancer after neoadjuvant chemotherapy

The paper describes a clinical case of successful combined modality treatment of a patient with pancreatic ductal adenocarcinoma with extension to the superior mesenteric artery and vein. The examination revealed an unresectable tumor. Twelve courses of FOLFIRINOX therapy showed good results, upon which the treatment plan was changed and a typical pancreaticoduodenal resection was performed. Pathological examination revealed ductal adenocarcinoma urT1N0M0R0, TRG 2. The postoperative period was uneventful. The efficacy of drug treatment for ductal adenocarcinoma has increased markedly in recent years. Neoadjuvant chemotherapy can be considered the most effective for locally advanced tumors.

Keywords:
pancreas, ductal adenocarcinoma, pancreaticoduodenal resection, locally advanced cancer, neoadjuvant chemotherapy, pathomorphosis