胰腺癌肉瘤是一种非常罕见的恶性肿瘤,预后不良。因为这些特点,尚未建立治疗策略。这项研究的目的是建立胰腺癌肉瘤的治疗策略。我们回顾了一名65岁女性患者的数据,该患者在手术前通过内窥镜超声引导下细针穿刺活检被诊断为胰腺癌肉瘤。对于文献综述,我们使用“胰腺”或“胰腺”和“癌肉瘤”或“癌肉瘤”搜索PubMed。患者接受了11个周期的亚叶酸新辅助治疗,氟尿嘧啶,伊立替康,奥沙利铂和帕博利珠单抗,因为肿瘤是临界可切除的。她接受了5分35Gy的立体定向消融身体放射治疗(SABR),其次是机器人保留幽门胰十二指肠切除术。手术后,患者接受与手术前相同方案的辅助化疗.她还活着,没有复发。在33篇可用论文中的48名患者中,中位生存时间为15个月.接受辅助化疗的患者生存率往往高于未接受辅助化疗的患者,尽管差异无统计学意义(中位生存期,47vs.15个月;p=0.485)。3例接受新辅助化疗的患者生存期为13-23.5个月。淋巴结清扫术,辅助治疗,新辅助治疗被认为有助于改善生存结局.传统胰腺导管腺癌的现代治疗方法可应用于胰腺癌肉瘤。
Pancreatic carcinosarcoma is a very rare malignancy with a poor prognosis. Because of these characteristics, a treatment strategy for it has not been established yet. The aim of this study was to establish a therapeutic strategy for pancreatic carcinosarcoma. We reviewed data of a 65-year-old female patient who was diagnosed with pancreatic carcinosarcoma through endoscopic ultrasound-guided fine needle aspiration biopsy before surgery. For literature review, we searched PubMed using terms of \"Pancreatic\" or \"Pancreas\" and \"carcinosarcoma\" or \"carcinosarcomatous\". The patient received 11 cycles of neoadjuvant treatment with leucovorin, fluorouracil, irinotecan, oxaliplatin and pembrolizumab because the tumor was borderline resectable. She underwent stereotactic ablative body radiotherapy (SABR) with 35 Gy in 5 fractions, followed by robotic pylorus-preserving pancreaticoduodenectomy. After surgery, the patient received adjuvant chemotherapy in the same regimen as before surgery. She is alive without any recurrence. Among 48 patients within 33 available papers, the median survival time was 15 months. The survival rate of patients who received adjuvant chemotherapy tended to be higher than that of those who did not receive adjuvant chemotherapy, although the difference was not statistically significant (median survival, 47 vs. 15 months; p = 0.485). Three patients who received neoadjuvant chemotherapy had a survival period of 13-23.5 months. Surgery with lymphadenectomy, adjuvant therapy, and neoadjuvant therapy are thought to help improve survival outcomes. Modern treatment approaches for conventional pancreatic ductal adenocarcinoma could be applied to pancreatic carcinosarcoma.