[A long survival case of unresectable pancreatic cancer by chemoradiotherapy with gemcitabine as key drug].

A 64-year-old man complaining of left hypochondriac pain visited our hospital. He was diagnosed as locally advanced unresectable cancer of the pancreatic body over 4 cm in size, because the pancreatic cancer involved the main artery and portal vein. Although chemotherapy of gemcitabine(GEM)(1.2 g/body/week)was started, he developed meningeal carcinomatosis after 2 courses of GEM. The size of the primary lesion decreased at this period, and total brain irradiation was selected to treat the meningeal carcinomatosis. He sequentially received GEM alone afterward until radiotherapy was performed for the progression of the primary lesion 24 months after the diagnosis. Although GEM alone was continued thereafter, vertebral metastases were detected 30 months following the diagnosis. He was treated with combined chemotherapy of GEM and S-1 that was effective. Finally, he died of peritoneal dissemination 42 months after diagnosis. The dose of GEM was reduced during the radiotherapy, and the total dose was 113.2 g.