Böhmig M, Wiedenmann B, Rosewicz S
Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Med Klin (Munich). 1999 Nov 15;94(11):614-25. doi: 10.1007/BF03045002.
Despite significant advances in the areas of epidemiology, risk factors, molecular genetics and diagnosis pancreatic carcinoma is characterized by a dismal prognosis and ranks 5th among malignancy-associated deaths. This article attempts to critically review the current literature and analyze therapeutic recommendations based on published evidence. Therapeutic options are based on the stage of the disease.
Surgical resection with curative intention is feasible only in a minority of patients presenting with locally confined tumor disease. RADIO- AND CHEMOTHERAPY: Adjuvant combined radiochemotherapy might potentially improve survival and can also be considered in unresectable, locally advanced disease. The role of chemotherapy in advanced disease is exclusively palliative. Up to now, no chemotherapeutic regimen has demonstrated convincing impact on survival. Newer substances, such as gemcitabine, appear to be of some value in respect to quality of life. Best supportive care oriented at clinical symptoms remains a cornerstone in the therapeutic concept of patients with pancreatic carcinoma.
Development of innovative therapeutic strategies is therefore mandatory.
尽管在流行病学、危险因素、分子遗传学和诊断领域取得了重大进展,但胰腺癌的预后仍然很差,在恶性肿瘤相关死亡中排名第五。本文试图批判性地回顾当前文献,并根据已发表的证据分析治疗建议。治疗方案基于疾病分期。
仅少数局部局限性肿瘤疾病患者可行根治性手术切除。
辅助性联合放化疗可能会提高生存率,也可用于不可切除的局部晚期疾病。化疗在晚期疾病中的作用仅是姑息性的。到目前为止,尚无化疗方案对生存率有令人信服的影响。新的药物,如吉西他滨,在生活质量方面似乎有一定价值。针对临床症状的最佳支持治疗仍然是胰腺癌患者治疗理念的基石。
因此,必须制定创新的治疗策略。