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Hepatobiliary and Pancreatic Cancers

For elderly patients with pancreatic cancer, treatment should aim for stability while striving for success

时间:2026-04-22 人气:

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Overview of the disease


 
Ms. Li, 68 years old, underwent an abdominal and pelvic CT scan in December 2018, which revealed a low-attenuation mass with a rough margin in the pancreatic body, suggesting the possibility of pancreatic body cancer with adjacent structural involvement. Following the diagnosis, a pancreatic mass biopsy was performed, revealing poorly differentiated cancer infiltration. On May 6, 2019, under general anesthesia, a laparoscopic exploration and open radical resection of the pancreatic body and tail were performed. Postoperative pathology indicated moderately-to-poorly differentiated adenosquamous carcinoma.
From June 25, 2019, to September 24, 2019, she underwent four cycles of adjuvant chemotherapy with gemcitabine and temozolomide.
A follow-up abdominal CT scan on June 18, 2019, showed residual pancreatic body and tail, spleen, and left adrenal gland after resection; and an accumulation of fluid in the abdominal and pelvic cavity.
On September 26, 2019, an upper abdominal MR plain scan revealed changes after resection of the pancreatic body and tail, spleen, and left adrenal gland; suspicious abnormal signals in the residual pancreatic parenchyma; and abnormal signals in the right lobe of the liver.
Department
   
Pu
Small
Knowledge

Knowledge


 
Pancreatic cancer  

Pancreatic cancer, known as the "king of cancers," is a tumor with extremely poor prognosis in clinical practice. The occurrence of pancreatic cancer is closely related to unhealthy lifestyles such as smoking, drinking, high-fat and high-protein diets, excessive coffee consumption, and genetic factors. Recent studies have shown that the incidence rate of pancreatic cancer in diabetic patients is significantly higher than that in the general population. Because there are usually no symptoms in the early stages, it is difficult to detect early, and often by the time it is diagnosed, metastasis has already occurred. As the disease progresses, tumor compression can cause symptoms such as jaundice and gastrointestinal bleeding.

Pancreatic cancer is highly malignant, and even after surgery, there is still a high risk of recurrence. Ms. Li and her family were very worried and sought the help of Professor Zhang Minghui's NKT treatment team at Tsinghua University School of Medicine. After carefully reviewing the case presentations of NKT cell therapy, they particularly hoped to try it to reduce the risk of tumor recurrence and delay the time of recurrence and metastasis.

After reviewing Ms. Li's medical records, Professor Zhang Minghui made the following analysis and judgment:
1. Pancreatic cancer is highly malignant, and the patient's pathological type is complex - "moderately-poorly differentiated" and "adenosquamous carcinoma" are indicators of poor prognosis.  
 

2. The patient developed postoperative peritoneal and pelvic effusion, which is considered to be caused by surgery.

3. The patient's routine follow-up after chemotherapy revealed suspicious signals in the residual pancreas and right lobe of the liver. Combined with the elevated tumor marker levels, the possibility of disease progression in the patient has increased.

4. Currently, the patient has no clear signs of recurrence or metastasis. To prevent this, NKT cell therapy can effectively function in cases with low tumor burden. NKT cells can kill residual tumor cells, prevent the aggregation of free cancer cells, and effectively reduce the risk of metastasis and recurrence.

From December 2019 to December 2022, Ms. Li completed a total of 28 courses of treatment. Through multiple follow-ups and imaging examinations, no clear signs of tumor recurrence were observed, and the overall evaluation reached a stable state for 36 months  

Imaging

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Tumor markers

 

Tumor markers: CEA showed intermittent mild elevation from September 2019 to September 2021, and returned to normal range during follow-up from December 2021 to December 2022; CA125 and CA19-9 were within normal range from September 2019 to December 2022; NSE was within normal range in September 2021, slightly elevated in December 2021, returned to normal range during follow-up in June 2022, and exceeded normal range in December 2022, requiring close monitoring.

 Conclusion and Comments


 

Ms. Li reported feeling more energetic than before. When she first finished her surgery, she needed assistance to walk and her quality of life score was only 78. Now, her appetite has improved, and her quality of life has been greatly enhanced. She reported fewer colds and fevers in spring and winter than before, and her overall quality of life is excellent, with a score of 90.5.

Ms. Li has been treated with NKT cell therapy for over three years, and multiple assessments have shown stable disease without progression.

Sampling survey of 90 day postoperative mortality rate in elderly patients over 70 years old from three developed countries
Ms. Li'stumor is a high-risk type, and under NKT cell therapy intervention, Ms. Li'scondition has been stabilized.. During this process, NKT cell immunotherapy plays an indispensable role in reducing the risk of recurrence and metastasis. It not only eliminates residual tumor cells, but also strengthens the immune system, thereby providing patients with long-term stability.
Popular science knowledge is for reference only, and individual patients should seek clinical treatment accordingly.   

Reference:< H365>

【1】Malvezzi M, Carioli G, Bertuccio P, et al. European cancer mortality predictions for the year 2019 with focus on breast cancer. Ann Oncol. 2019; 30(5):781–787

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