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🌱來自: snippets
PANCREATIC_ADJ
Pancreatic head (uncinate process) ductal (M/D) adenocarcinoma s/p laparoscopic Whipple operation on 2017/00/00, pT3N1(1/9)M0, stage IIB, margin involved by invasive carcinoma, LVI+, perineural invasion+, vascular invasion -, 2017/00/00 CT post-op changes
- Initial presentation:
- Treatment plan: adjuvant chemotherapy
- Follow up parameter: CA-199, abdominal CT scan
- 2017/00/00: The purpose of adjuvant treatment is to improve DFS and OS but not 100%. Adjuvant treatment should be administered to patients who have not had neoadjuvant chemotherapy and who have adequately ercovered from surgery; treatment would be initiated w/in 12 weeks. If systemic chemotherapy precedes CCRT, restaging with imaging should be done after each treatment modality. Patient who have recieved neoadjuvant CCRT or chemotherapy may be candidates for additional chemotherapy following surgery and multidisciplinary review. The adjuvant therapy options are dependent on the response to neoadjuvant therapy and other clinical considerations.
- 2017/00/00 Explain adjuvant chemotherapy treatment option, such as Gem alone (CONKO-001 study, 1000mg/m2 D1,8,15, q4w for 6 months, OS HR:0.76), 5FU/LV (425/20 IV bolus D1-D5 QM for 6 months, mOS 23.6 month), and GEM + capcitabine (1660mg/m2 D1-D21, Q4weeks, HR 0.82). Explain indcution chemotherapy followed by CCRT followed by subsequent chemotherapy: GEM/5FU ⇒ CCRT with 5FU or GEM ⇒ GEM/5FU. Explain CCRT with weekly 5FU/LV @ Explain treatment options, after