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Suggest treatment for recurrent pancreatic adenocarcinoma

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Posted on Mon, 1 Jun 2015
Question: Sir,
Recurrence pancreatic adenocarcinoma.
Ca 19 9 levels -250.
Celiac lymph nodes metases.
On pet scan.no cancer anywhere else.
Doc advised folfirinox. 3 cycles.
Followed by radiation.
Liver function test -normal.

Doctor said localised recurrence.
Please suggest prognosis. XXXXXXX Makharia.
doctor
Answered by Dr. Indranil Ghosh (30 minutes later)
Brief Answer:
yes folfirinox is a suitable regime

Detailed Answer:
Hi
Thanks for your query.

It is a difficult scenario. Surgery unlikely to help. Hence chemotherapy with folfirinox is the treatment of choice. It has the highest response rates.

If there is a good response, radiation can be considered.

Now the unfortunate part is that even though localized recurrence, it is not curable. We can however try controlling it as long as possible.

Hope this helps. I will be available for follow up.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (2 minutes later)
life expectancy.
doctor
Answered by Dr. Indranil Ghosh (19 minutes later)
Brief Answer:
difficult to predict

Detailed Answer:
From my past experience I can say 1-2 years maybe.

However it is not possible to predict in an individual patient
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (10 minutes later)
Sir
there are 2 lymph nodes measuring 1.4 cm and 1 cm.
in my case life expectancy and progression free survival
doctor
Answered by Dr. Indranil Ghosh (58 minutes later)
Brief Answer:
disease burden low so it may be more

Detailed Answer:
But still the average progression free survival with FOLFIRINOX is about 6-12 months and life expectancy 1-2 years. In any individual case very difficult to predict. Some patients may even survive 5 years but that is a small proportion.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1668 Questions

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Suggest treatment for recurrent pancreatic adenocarcinoma

Brief Answer: yes folfirinox is a suitable regime Detailed Answer: Hi Thanks for your query. It is a difficult scenario. Surgery unlikely to help. Hence chemotherapy with folfirinox is the treatment of choice. It has the highest response rates. If there is a good response, radiation can be considered. Now the unfortunate part is that even though localized recurrence, it is not curable. We can however try controlling it as long as possible. Hope this helps. I will be available for follow up. Regards