Raraty Michael G T, Magee Conor J, Ghaneh Paula, Neoptolemos John P
Department of Surgery, University of Liverpool, Royal Liverpool University Hospital, Liverpool, UK.
Acta Oncol. 2002;41(7-8):582-95.
Pancreatic ductal adenocarcinoma represents a major oncological challenge. Despite improvements in surgical techniques, long-term survival after resection is poor, with few patients surviving after 5 years. Until recently, there have been no large randomized trials of adjuvant therapy in pancreatic ductal adenocarcinoma. However, major trials such as the European Study Group for Pancreatic Cancer (ESPAC-1) and ESPAC-3 trials have set new standards for patient recruitment and development in this field. Adjuvant therapy has the potential to improve both patient survival and quality of life after curative resection. Currently, the best treatment is with 5-fluorouracil with folinic acid, but in the light of ongoing clinical trials, this may be supplanted by gemcitabine as the treatment of choice. Chemoradiotherapy does not appear to be beneficial in the adjuvant setting, but trials of a wide variety of other techniques and agents in the treatment of advanced disease are being undertaken and some of these will almost certainly be extended into the adjuvant setting in time. Great progress has been made in the adjuvant treatment of pancreatic cancer in the past 10 years and similar advances are likely over the next decade.
胰腺导管腺癌是一项重大的肿瘤学挑战。尽管手术技术有所改进，但切除术后的长期生存率仍很低，5年后存活的患者寥寥无几。直到最近，还没有针对胰腺导管腺癌辅助治疗的大型随机试验。然而，诸如欧洲胰腺癌研究组（ESPAC-1）和ESPAC-3试验等主要试验为该领域的患者招募和研究设定了新的标准。辅助治疗有可能提高根治性切除术后患者的生存率和生活质量。目前，最佳治疗方案是使用5-氟尿嘧啶加亚叶酸，但鉴于正在进行的临床试验，吉西他滨可能会取代5-氟尿嘧啶成为首选治疗药物。在辅助治疗中，放化疗似乎并无益处，但目前正在开展针对晚期疾病的各种其他技术和药物的试验，其中一些几乎肯定会适时扩展到辅助治疗领域。在过去10年里，胰腺癌的辅助治疗取得了巨大进展，未来10年可能会有类似的进展。
