Multidisciplinary Treatment Comprising Heavy Particle Radiotherapy and Hyperthermia is Effective Against Liver Metastasis Arising from Pancreatic Cancer: A Case Report

Pancreatic cancer is a leading cause of cancer-related deaths. Although advances in chemotherapy and radiotherapy have improved patient outcomes, pancreatic cancer remains a refractory disease. Herein, we describe a patient with pancreatic cancer who underwent an effective multidisciplinary treatment comprising heavy particle radiotherapy and hyperthermia. A 64-year-old woman underwent distal pancreatectomy for pancreatic cancer; however, a single liver metastasis was discovered 12 months after surgery. Heavy particle radiotherapy and oral tegafur/gimeracil/oteracil were administered to treat the metastasis. Thereafter, the patient underwent laparoscopic lateral segmentectomy of the liver. However, 12 months after hepatectomy, peritoneal dissemination with elevated serum carbohydrate antigen 19-9 levels was detected. The patient received combination therapy with gemcitabine and nanoparticle albumin-bound paclitaxel and subsequently underwent hyperthermia therapy with low-dose S-1 administration. While serum carbohydrate antigen 19-9 levels decreased more than expected over the first 9 months of hyperthermia therapy, the patient died the following month. Overall, the patient survived for 4 years after liver metastasis was detected and 3 years post-peritoneal dissemination. In an era where novel therapeutic strategies are required for treating aggressive malignancies, our report illustrates the potential effectiveness of multidisciplinary treatments in patients with unresectable pancreatic cance