Proton therapy for pancreatic cancer

Abstract

Introduction J.H.K., a 56-year-old male was admitted with jaundice. The patient reported significant weight loss and fatigue. Case history The patient was diagnosed with the pancreatic head adenocarcinoma with a single isolated lung metastasis status post a lung resection and extended duration systemic chemotherapy and consolidative chemoradiation. The patient underwent 12 cycles of systemic FOLFIRINOX which he has tolerated incredibly well and had a marked biochemical radiographic and metabolic response. He has undergone PBT (proton beam therapy) (15 fractions, 4500 cGy). The patient presents for a routine follow-up after completion of neoadjuvant chemoradiotherapy and pancreaticoduodenectomy (Whipple resection) was performed. He had a good Treatment response with a CAP score of 1, indicating a near-complete response. He was properly recovering from surgery and described no significant toxicities at this time. Currently, he has no evidence of any disease. Investigations He was diagnosed with borderline resectable pancreatic adenocarcinoma by using biopsy before surgery. Also, he had elevated CA 19-9. Postoperative lung right middle lobe, wedge resection showed metastatic poorly differentiated adenocarcinoma in the lung consistent with the pancreatic primary. Post-operative status: ductal adenocarcinoma was diagnosed, his overall stage is pT1c N0 M1, additional pathologic findings showed chronic pancreatitis and duodenal ulcer. Results The patient benefits from neoadjuvant Treatment. Extended duration systemic chemotherapy and PBT led the patient to radical pancreaticoduodenectomy.[...].