| セッション情報 |
シンポジウム17(消化器内視鏡学会・消化器病学会合同)
Role of oncologists and endoscopists in the management of biliary tract and pancreatic disease≪Abstract and slide：English, Presentation：Japanese≫
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| タイトル |
内S17-11：Chemotherapy and endoscopic management for patients with unresectable pancreatic cancer
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| 演者 |
T. Mukai（Department of Gastroenterology, Gifu Municipal Hospital） |
| 共同演者 |
I. Yasuda（First Department of Internal Medicine, Gifu University Hospital）, E. Tomita（Department of Gastroenterology, Gifu Municipal Hospital） |
| 抄録 |
Chemotherapy and endoscopic management of obstructive jaundice and cancer pain play important role in improving the QOL and prognosis of patients (pts) with unresectable pancreatic cancer (UPC).Aims: To evaluate the efficacy of chemotherapy, EBS, and EUS-CPN/CGN for the treatment of UPC.Patients and Methods: We retrospectively evaluated 280 pts with UPC, who were treated between Apr 2001 and Dec 2011.Results: Chemotherapy mainly with GEM was performed for ≧2 sessions in 173 and in ＜2 session or BSC in 107 pts. EBS was performed in 174, and EUS-CPN/CGN was performed in 74 pts. The median survival time(MST) in patients with ≧2 sessions of chemotherapy was 257 days and was significantly longer than that in the remaining pts(128 days). As an initial stent for biliary obstruction, a PS was used in 58 pts and a cSEMS was used in 116. The median period of stent patency was 99 days in the PS and 312 days in the cSEMS group. EUS-CPN and CGN were performed in 39 and 35pts. A good response (VAS≦3) was noted in 26(67%)and 29(83%), and complete response (VAS≦1) was observed in 18(46%)and 25(71%), respectively.Conclusion: MST of more than 8 months was achieved with chemotherapy in pts with UPC. Endoscopic biliary management with cSEMS had a significantly longer stent patency period and needed less reintervention as compared to PS. Both EUS-CPN/CGN proved effective for CP treatment. In particular, significantly better pain management was achieved by using EUS-CGN as compared to that achieved using EUS-CPN. In the management of UPC, a multidisciplinary approach required because of various existing complications in a patient. |
| 索引用語 |
pancreatic cancer, endoscopic management |
