Matsuno S, Egawa S, Arai K
First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
J Hepatobiliary Pancreat Surg. 2001;8(6):544-8. doi: 10.1007/s005340100023.
Although surgical resection is considered to be the only approach that offers a possibility of cure to patients with pancreatic cancer, the prognosis of the disease has not been improved markedly by any surgical procedures in the past 20 years. Large-scale randomized prospective clinical trials are being conducted in the United States and Italy, comparing standard lymph node dissection with extended lymph node dissection. Although preoperative chemoradiation has various advantages in the treatment of pancreatic cancer, it does not contribute to its downstaging and eventual cure. The combination of leucovorin, 5-fluorouracil (5-FU), and extracorporeal irradiation, however, has been proven to improve the patient's quality of life (QOL). Palliative surgery still requires further research in areas such as the examination of morbidity rates and the duration of bypass effects, now that laparoscopic and endoscopic surgery have both been well developed. Recent biological research has revealed the mechanisms of the carcinogenesis and the progression of pancreatic cancer, and, against this background, we assume that more effective trials will be conducted soon. Immunotherapy with dendritic cells, as well as gene therapy with mutant adenovirus, has already been employed clinically. Pancreatic cancer therapy is now facing new prospects.
虽然手术切除被认为是唯一有可能治愈胰腺癌患者的方法，但在过去20年里，任何手术方式都未能显著改善该疾病的预后。美国和意大利正在进行大规模随机前瞻性临床试验，比较标准淋巴结清扫术和扩大淋巴结清扫术。虽然术前放化疗在胰腺癌治疗中有诸多优势，但它并不能使肿瘤降期，也无法实现最终治愈。然而，亚叶酸、5-氟尿嘧啶（5-FU）与体外照射联合使用，已被证明可改善患者的生活质量（QOL）。鉴于腹腔镜手术和内镜手术都已得到充分发展，姑息性手术在诸如发病率检查和旁路效果持续时间等方面仍需进一步研究。最近的生物学研究揭示了胰腺癌的致癌机制和进展过程，在此背景下，我们预计很快会开展更有效的试验。树突状细胞免疫疗法以及突变腺病毒基因疗法已在临床应用。胰腺癌治疗如今正面临新的前景。
