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PANCREATIC

Dec 05, 20232 min read

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🌱來自: snippets

PANCREATIC

Pancreatic cancer, head/neck/body/tail, adenocarcinoma (by ascites cytology), stage IV with liver mets (FNA), peritoneal carcinomatosis, malignant ascites, diagnosed on 2010/00/00

  • Initial presentation:
  • Treatment plan: palliative chemotherapy
  • Follow up parameter: CA-199, abdominal CT scan
  • 2010/00/00: the purpose of palliative chemotherapy is to control disease and prolong life and maintain quality of life but not cure. Explain high risk for bowel obstruction, biliary obstruction, infection, and need frequent paracentesis due to ascites and etc
  • 2010/00/00 - explain palliative chemotherapy treatment option, such as Gem-based, 5FU-based such as TS-1, and etc, 1st line treatment suggested Gemcis or gemox or gem or gem + nab-paclitaxel alone depends on performance status, FOLFIRINOX has promising OS benefits but very high toxicity. Other self-paid options includes gemcitabine + erlotinib. 2nd line treatment suggested liposome-irinotecan (NHI reimbursed after gemcitabine failure, or taxol (self-paid)). @ Start palliatve chemotherapy, explain treatment options, after discussion, patient prefer ?. Announce stage IV pancreatic cancer, poor prognosis. @ Vascular assessment (refer to NS for port A), nutritional assessment, dental check, pharmacist education before chemotherapy.

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