Combined chemotherapy, radiotherapy, and immunotherapy for pancreatic carcinoma--a case report

Therapeutic modalities for incompletely resected pancreatic carcinoma are rare. Effective treatment must not only prolong the period of palliation but also limit the adverse sequelae of the Whipple procedure so as not to compromise the quality of the remaining life span. New treatments include the use of gemcitabine and type I interferons. We treated a patient with incomplete resection of a pancreatic tumor with two cycles of gemcitabine (1000 mg/m2) and cisplatinum (50 mg/m2) followed by radiotherapy (45 Gy/5 weeks) combined with interferon-beta (three times a week/5 x 10(6) IU). Two small liver metastases occurred subsequently. In all, four cycles of gemcitabine/cisplatinum were delivered. The patient lived at least 9 months with stable metastatic liver disease and local control. He had no acute toxic reactions except for a decrease in the leukocyte count, no long-term side effects, and a satisfactory quality of life. A regimen of sequential gemcitabine/cisplatinum and radiotherapy in combination with interferon-beta deserves further consideration as therapy for pancreatic carcinoma.