scholarly journals Multidisciplinary approach for Borderline pancreatic adenocarcinoma of the head of the pancreas

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S318
Author(s):  
R. Rhaiem ◽  
O. Delchet ◽  
A. Tashkandi ◽  
S. Deguelte ◽  
M. Brasseur ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Multidisciplinary Approach ◽  
Head Of The Pancreas

Safety and efficacy of modified dose-attenuated FOLFIRINOX chemotherapy in patients over 65 years with advanced pancreatic adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15176-e15176 ◽  
Author(s):  
Matheus Bongers Alessandretti ◽  
Erika Pereira Brandao ◽  
Carina Meira Abrahão ◽  
Aline Rocha Lino ◽  
Rodnei Macambira Junior ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Therapeutic Option ◽  
Progression Free Survival ◽  
Complete Response ◽  
Tumor Location ◽  
Ethical Committee Approval ◽  
Head Of The Pancreas ◽  
Grade 3 ◽  
Few Data ◽  
Advanced Pancreatic Adenocarcinoma

e15176 Background: Few data regard efficacy and safety of FOLFIRINOX (oxaliplatin 85 mg/m2, irinotecan 180 mg/m2, fluorouracil bolus of 400 mg/m2 and continuous infusion of 2400 mg/m2 over 46 hours and leucovorin 400 mg/m2) in patients over 65 years with advanced pancreatic adenocarcinoma. Methods: After Ethical Committee approval, consecutive patients age over 65 with biopsy proven pancreatic adenocarcinoma that received at least one cycle of modified dose-attenuated FOLFIRINOX (no bolus FU and reduced dose of at least one agent since first cycle) were selected (São José Hospital database) for a retrospective review for safety, response, and survival. Results: Nineteen consecutive patients were selected from our database. Patients characteristics included 12 (63,1%) males, 7 (36,9 %) females, median age 72,7 (range 66-79). Tumor location was 11 (57,8 %) head of the pancreas, 6 (31,57 %) body and 2 (11 %) in other sites. Grade 3/4 toxicities were reported in 10 patients (52,6 %): nausea/vomiting 1 (5,2 %), diarrhea 1 (5,2 %), fatigue 3 (15,7%), neutropenia 4 (21 %), thrombocytopenia 1 (5,2%) and febrile neutropenia 3 (15,6 %). Elevations in AST and ALT above the upper limit of normality were identified in 5 (26,31%). No deaths reported due to toxicity. Prophylactic granulocyte colony stimulator factor (G-CSF) was given to 14 (73 %). Seventeen patients completed at least four cycles; disease control was obtained in 15 (83, 3 %) with 1 complete response, 5 partial response and 9 stable diseases. Median reductions in doses in the first cycle of chemotherapy by drugs were: oxaliplatin 23,3 % (10%-30%), irinotecan 24,6 % (0%-60%), fluorouracil 20,6% (0%-40%). Median reductions in doses in the fourth cycle of chemotherapy by drugs were: oxaliplatin 20,8 % (0%-42%), irinotecan 24,9 % (0%-75%), fluorouracil 17,6% (0%-40%).With a median follow up of 4.5 months, median overall or progression free survival is not reached. Conclusions: Modified dose-attenuated FOLFIRINOX is a therapeutic option to elderly with advanced pancreatic adenocarcinoma. Although grade 3 and 4 toxicities were reported, they were manageable. Modified attenuated-dose of FOLFIRINOX needs further investigated.

Modified FOLFIRINOX for metastatic pancreatic adenocarcinoma after failure of nab-paclitaxel plus gemcitabine.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 467-467
Author(s):  
Masato Ozaka ◽  
Takashi Sasaki ◽  
Seita Kataoka ◽  
Ryo Kanata ◽  
Kazunaga Ishigaki ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Objective Response ◽  
Kidney Injury ◽  
Phase Iii ◽  
Line Treatment ◽  
First Line ◽  
Start Date ◽  
Metastatic Pancreatic Adenocarcinoma ◽  
Head Of The Pancreas ◽  
Grade 3

467 Background: Both FOLFIRINOX and Nab-paclitaxel plus Gemcitabine standard treatment in first-line treatment of metastatic pancreatic adenocarcinoma (MPA). It could be of interest to use them consecutively, knowing that there is currently no standard for 2nd line treatments for MPA. The aim of this study was to evaluate the efficacy and tolerability of modified FOLFIRINOX after gemcitabine plus Nab-paclitaxel failure in MPA. Methods: From January 2015 to March 2016, medical records were retrospectively reviewed for consecutive patients receiving modified FOLFIRINOX for a histologically proven MPA after failure of Nab-paclitaxel plus Gemcitabine. Patients were treated with modified FOLFIRINOX every 2 weeks as follows: intravenous oxaliplatin 85 mg/m2, irinotecan 150 mg/m2, 5-FU infusion 2,400 mg/m2 over 46 h, no bolus 5-FU, until disease progression, patient refusal or unacceptable toxicity. Results: Modified FOLFIRINOX was administered to 23 pts. Among these patients, median age was 64 years (range 42.4 - 74.2). 83% of the patients had a PS 0, the primary site of the tumor was the head of the pancreas in 39% of patients, and 26% of patients experienced recurrence after resection. Disease control rate was 66.7% (n = 17) with a 23.8 % (n = 17) objective response rate (RECIST). Within the whole cohort, median PFS was 4.3 months (95% CI: 3.1-5.3) and median overall survival (OS) was 9.3 months (95% CI: 3.8-14.8). Since the start date of first line chemotherapy with Nab-paclitaxel plus Gemcitabine, median OS was 18.8 months (95% CI: 9.6-27.9). No toxic death occured. Grade 3-4 toxicities were reported in 30% of patients and were neutropenia (17%), anemia (8%), cholangitis (8%) and acute kidney injury (4%). Conclusions: Modified FOLFIRINOX seems promising with a manageable toxicity profile after Nab-paclitaxel plus Gemcitabine failure, in selected patients able to receive second line treatment for a MPA. These promising results have now to be confirmed in a phase III randomized trial.

scholarly journals Pancreatic intraepithelial neoplasia and ductal adenocarcinoma induced by DMBA in mice: effects of alcohol and caffeine

2007 ◽  
Vol 22 (3) ◽  
pp. 202-209 ◽  
Author(s):  
Luiz Roberto Wendt ◽  
Alessandro Bersch Osvaldt ◽  
Vivian Pierre Bersch ◽  
Rita de Cássia Schumacher ◽  
Maria Isabel Albano Edelweiss ◽  
...  
Keyword(s):  
Mouse Model ◽  
Pancreatic Adenocarcinoma ◽  
Intraepithelial Neoplasia ◽  
Ductal Adenocarcinoma ◽  
Pancreatic Intraepithelial Neoplasia ◽  
Alcohol Group ◽  
Pancreatic Carcinogenesis ◽  
Head Of The Pancreas ◽  
Reactive Hyperplasia ◽  
Hematoxylin Eosin

PURPOSE: To evaluate the effects of alcohol and caffeine in a pancreatic carcinogenesis mouse model induced by 7,12-dimethylbenzantracene (DMBA), according to the PanIN classification system. METHODS: 120 male, Mus musculus, CF-1 mice were divided into four groups. Animals received either water or caffeine or alcohol or alcohol + caffeine in their drinking water. In all animals, 1 mg of DMBA was implanted into the head of the pancreas. After 30 days, euthanasia was performed; excised pancreata were then fixed in formalin, stained with hematoxylin-eosin and categorized as follows: normal ducts, reactive hyperplasia, PanIN-1A, PanIN-1B, PanIN-2, PanIN-3 or adenocarcinoma. RESULTS: PanIN lesions were verified in all groups. Adenocarcinoma was detected in 15% of animals in the caffeine group, 16.6% in the water group, 23.8% in the alcohol + caffeine group and 52.9% in the alcohol group (P<0.05). CONCLUSIONS: The experimental pancreatic carcinogenesis mouse model using DMBA effectively induces PanIN lesions and pancreatic adenocarcinoma. This study verified the association between alcohol use and pancreatic adenocarcinoma; caffeine did not present the same effect.

The natural history of preoperative indeterminate pulmonary nodules in patients with resectable pancreatic adenocarcinoma.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 161-161
Author(s):  
Dennis C. Nguyen ◽  
Stephanie Chang ◽  
Zhou Gongfu ◽  
Andrea Wang-Gillam ◽  
David Linehan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Natural History ◽  
Pancreatic Adenocarcinoma ◽  
Preoperative Evaluation ◽  
Pulmonary Nodules ◽  
Metastatic Adenocarcinoma ◽  
History Of ◽  
Head Of The Pancreas ◽  
Ground Glass Nodules

161 Background: Preoperative abdominal imaging often detects indeterminate pulmonary nodules (IPN) in patients with resectable pancreatic adenocarcinoma. The natural history of IPN in this setting is not well characterized. Methods: Patients with adenocarcinoma of the head of the pancreas who underwent pancreaticoduodenectomy (PD) were queried from a prospectively maintained database. Pre- and postoperative imaging was reviewed and IPN characterized and analyzed for associations with nodule progression and overall survival (OS). Results: 463 patients underwent PD for adenocarcinoma of the head of the pancreas from 2000-2010. Of these, 329 (71%) had reviewable pre-operative imaging. 48 patients (15%) had pre-operative IPN (non-calcified) identified with follow-up imaging available for review. The only pre-operative factor associated with the presence of IPN was increasing age (68 v. 64 years; p=0.003). 8 patients (12%) had new or enlarging nodules, of whom 5 (7%) had confirmed pulmonary metastatic adenocarcinoma. There was no difference in OS between patients with or without pre-operative IPN (2-year OS 41% v. 38%, respectively; p=0.37). Further, no radiographic criteria of IPN (including # of, size of, bilateral, calcified, solid, spiculated, smooth, lobular, or ground-glass nodules) was associated with OS. On follow-up, new or enlarging nodules were not associated with OS. Conclusions: IPN are often found in patients undergoing PD for pancreatic adenocarcinoma. The majority of IPN remain stable on post-operative imaging. Neither the presence of IPN nor nodule characteristics was associated with OS. These data do not support the routine additional workup of pre-operative IPN in patients with resectable adenocarcinoma of the head of the pancreas; however, larger studies are needed to further characterize the significance of IPN in the preoperative evaluation of patients with pancreatic adenocarcinoma.

The Immune Landscape in a Long-Term Survival Pancreatic Adenocarcinoma Patient Highly Responsive to a Multidisciplinary Approach With Chemo-Radio Treatments

Pancreas ◽  
2021 ◽  
Vol 50 (9) ◽  
pp. e76-e78
Author(s):  
Marialuisa Barbagallo ◽  
Debora Ciprani ◽  
Lorenza Rimassa ◽  
Nina Cortese ◽  
Tiziana Comito ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Multidisciplinary Approach ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Routes and types of microbial infection in the pathology of pancreatic adenocarcinoma

2021 ◽  
pp. 71-71
Author(s):  
Dragan Nikolic ◽  
Stojan Latincic ◽  
Milos Stojanovic ◽  
Nikica Grubor ◽  
Lazar Ranin ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Pancreatic Adenocarcinoma ◽  
Bacterial Infections ◽  
Duodenal Mucosa ◽  
Pancreatic Tissue ◽  
Coagulase Negative Staphylococcus ◽  
Microbial Infection ◽  
Papilla Vateri ◽  
Enterococcus Spp ◽  
Head Of The Pancreas

Introduction/Objective. Pancreatic cancer may be accompanied by infections caused by various microorganisms. It is uncertain wheatear pancreatic infection precedes development of cancer or vice versa. The aim of this study is to analyze routes of infections from duodenum through pancreatic duct to determine what types of microorganisms can get through this duct into pancreas and nearby tissue. Methods. In patients subjected to cephalic duodenopancreatectomy sec. Whipple due to adenocarcinoma of papilla Vateri, duodenum or head of the pancreas, swabs from duodenal mucosa, pancreatic duct and pancreatic tissue at the line of the resection, were taken. Microscopic slides were prepared directly from patients? specimens and also from colonies on culture plates and both were Gram stained. Results. Candida was present in all three types of swabs (duodenum, pancreatic duct and tissue), while bacteria, depending of the species (Pseudomonas aeruginosa. ? hemolytic Streptococcus, Coagulase Negative Staphylococcus, Enterococcus spp, Serratia spp), were present in pancreatic duct or tissue, but not in duodenum. Conclusion. There is connection between presence of microorganisms and pathology of the pancreatic adenocarcinoma. Results show that Candida infection originates from duodenum, while bacterial infections originate directly from blood or tissue injuries.

AAC Supports for Individuals With Rett Syndrome Across the Lifespan

2015 ◽  
Vol 24 (3) ◽  
pp. 74-85
Author(s):  
Sandra M. Grether
Keyword(s):  
Rett Syndrome ◽  
Communication Skills ◽  
Preliminary Analysis ◽  
Multidisciplinary Approach ◽  
Motor Deficits ◽  
Complex Profile ◽  
Communication Behaviors ◽  
The Individual

Individuals with Rett syndrome (RS) present with a complex profile. They benefit from a multidisciplinary approach for diagnosis, treatment, and follow-up. In our clinic, the Communication Matrix © (Rowland, 1990/1996/2004) is used to collect data about the communication skills and modalities used by those with RS across the lifespan. Preliminary analysis of this data supports the expected changes in communication behaviors as the individual with RS ages and motor deficits have a greater impact.

Sign in / Sign up

Export Citation Format

Share Document