演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

切除不能十二指腸神経内分泌腫瘍(NET)に対するストレプトゾシン単剤の1使用例

演題番号 : P110-7

[筆頭演者]
演者)宮川 公治:1 
[共同演者]
中林 雄大:1、石原 陽介:1、藤堂 桃子:1、藤 信明:1

1:済生会京都府病院・外科

 

[Introduction] We experienced a case in which long-term survival was obtained by administering monotherapy of streptozocin to the recurrent NET of duodenal neuroendocrine tumor
[Case] A 57-year-old man. Pancreaticoduodenectomy was performed on the duodenal bulb NET ,G2( T1N1M0 StageIIIb) in December 2015. Since multiple hepatic metastasis was recognized 6 months after the operation, TACE (Lipiodol) was performed but it was PD.
Thereafter, everolimus was administered, but the elevation of CA 19 - 9 was observed at the 6th month of administration, and the PD on the image was confirmed. Starting administration of streptozocin from May 2017 (monotherapy 1000 mg / m 2 Weekly dosing regimen), CA 19 - 9 declined at the third administration and normalized at the fifth time.The normal value is maintained for one year thereafter. In the imaging examination one year after starting administration of streptozocin, it is SD, pogression free survival time exceeds 1 year.[Discussion] Duodenal NET is very rare, there are few reported cases in Japan, so there are not many options for treatment for unresectable lesions.Streptozocin is recommended grade C1 as 'Recommended case without other options' in the clinical practice guidelines of Japan Society of Neuroendocrine Oncology (JNETS).On the other hand, although not recommended in the European Neuroendocrine Oncology Association (ENETS) 2016 guideline, it is stated that it may be considered.In Europe and the United States, chemotherapy for pancreatic gastrointestinal tract NET is not monotherapy of streptozocin but combination with 5 FU and DOX is standard, duodenal NET response rate is lower than pancreatic NET and the number of reports is small.As in the case of ourselves, since there are hardly any cases of effective use of streptozocin alone in domestic and overseas, we will report on literature considerations.

キーワード

臓器別:NET(神経内分泌腫瘍)

手法別:化学療法

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