Magee Conor J, Ghaneh Paula, Neoptolemos John P
Department of Surgery, University of Liverpool, 5th Floor UCD Building, Royal Liverpool University Hospital, Daulby Street, Liverpool, L69 3GA, UK.
Best Pract Res Clin Gastroenterol. 2002 Jun;16(3):435-55. doi: 10.1053/bega.2002.0317.
Progress on the treatment of pancreatic ductal adenocarcinoma has involved advances in medical and surgical care with important contributions from disciplines such as radiology and intensive care. In the last decade large randomized controlled trials have been undertaken that demonstrate the improved patient outcomes. There is an increased risk of pancreatic cancer in chronic pancreatitis, hereditary pancreatitis and a variety of familial cancer syndromes. The optimum outcome from pancreatic cancer needs management by multidisciplinary teams in regional specialist units. Endoscopic stenting, good pain relief and pancreatic enzyme supplementation are the basis of care in advanced pancreatic cancer. Chemotherapy prolongs survival in advanced pancreatic cancer with little to be gained using drugs other than 5FU. Resection, if possible, prolongs life and provides the best quality of life. Adjuvant chemoradiotherapy is of no benefit but chemotherapy may improve survival. Alongside the evolution in clinical management has been the elucidation of the molecular events that underlie pancreatic cancer and this knowledge has guided the introduction of targeted treatments for pancreatic cancer.
胰腺导管腺癌的治疗进展涉及医学和外科护理的进步，放射学和重症监护等学科也做出了重要贡献。在过去十年中，开展了大型随机对照试验，结果显示患者预后得到改善。慢性胰腺炎、遗传性胰腺炎和多种家族性癌症综合征患者患胰腺癌的风险增加。胰腺癌的最佳治疗效果需要由地区专科单位的多学科团队进行管理。内镜支架置入、良好的疼痛缓解和补充胰酶是晚期胰腺癌护理的基础。化疗可延长晚期胰腺癌患者的生存期，除5-氟尿嘧啶外，使用其他药物获益甚微。若有可能进行手术切除，则可延长生命并提供最佳生活质量。辅助放化疗并无益处，但化疗可能改善生存率。随着临床管理的发展，人们对胰腺癌潜在分子事件的认识也更加清晰，这些知识为胰腺癌靶向治疗的引入提供了指导。
