Chemotherapy with TS-1 + CDDP followed by curative operation for locally advanced duodenal cancer

A 53-year-old woman presented with back pain. She was admitted to hospital because a mass was detected in the right upper abdomen. Upper gastrointestinal endoscopy and hypotonic duodenography showed type 2 advanced cancer in the second portion of the duodenum. Computed tomography (CT) revealed a primary duodenal cancer with invasion to both the head of the pancreas and superior mesenteric vein. The patient was treated with combined chemotherapy using TS-1 and CDDP. TS-1 (80 mg_ m2) was orally administered for 3 weeks (day 1-21), and CDDP (60 mg_m²) was simultaneously administered on day 8 every 5 weeks. The chemotherapeutic regimen was repeated for 3 cycles. CT after chemotherapy revealed the tumor to have decreased in size, while also showing an improvement of the pancreas and superior mesenteric vein invasion. The patient thereafter underwent a curative pancreaticoduodenectomy. The pathological grade was determined to be Grade 1b. The resection margins were negative (R0). The patient was doing well and showed no signs of any recurrence of the cancer at 12 months after the initiation of therapy. TS-1_CDDP combination chemotherapy was effective for locally advanced duodenal cancer.