McGinn Cornelius J, Lawrence Theodore S, Zalupski Mark M
Department of Radiation Oncology, University of Michigan Health Systems, Ann Arbor, Michigan 48109-0010, USA.
Cancer. 2002 Aug 15;95(4 Suppl):933-40. doi: 10.1002/cncr.10754.
The use of chemotherapy with concurrent radiation therapy remains a standard treatment option for patients with unresectable or resected adenocarcinoma of the pancreas. This treatment strategy is based in large part on data from serial Gastrointestinal Tumor Study Group trials that have included 5-fluorouracil. Unfortunately, the majority of patients continue to succumb to the disease process. Recently, there has been a resurgence in clinical trials utilizing gemcitabine as a single agent, in combination chemotherapy regimens, and with concurrent radiation therapy. Use with concurrent radiation therapy is based in part on laboratory studies investigating mechanisms of radiosensitization and strategies that might increase the therapeutic index. In the current review, the authors summarize the preclinical data that support the use of gemcitabine as a radiosensitizing agent and the clinical trials that have been conducted to date. Issues regarding the use of gemcitabine in concurrent radiotherapy regimens need to be viewed in the context of both local and distant disease control, given the radiosensitizing and systemic activity of this agent.
对于无法切除或已切除的胰腺腺癌患者，化疗联合同步放疗仍然是一种标准的治疗选择。这种治疗策略很大程度上基于胃肠道肿瘤研究组系列试验的数据，这些试验中包含了5-氟尿嘧啶。不幸的是，大多数患者最终仍死于该疾病进程。最近，在临床试验中，吉西他滨作为单一药物、联合化疗方案以及联合同步放疗又重新兴起。联合同步放疗的应用部分基于研究放射增敏机制和可能提高治疗指数策略的实验室研究。在当前综述中，作者总结了支持将吉西他滨用作放射增敏剂的临床前数据以及迄今为止进行的临床试验。鉴于该药物的放射增敏和全身活性，在局部和远处疾病控制的背景下看待在同步放疗方案中使用吉西他滨的问题。
