Willett Christopher G, Clark Jeffrey W
Harvard Medical School, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Oncology (Williston Park). 2003 Dec;17(12 Suppl 13):29-36.
Cancer of the pancreas remains a formidable challenge in oncology. This malignancy ranks as the fourth leading cause of cancer death in the United States in 2003, with an estimated 30,700 new cases to be diagnosed and 30,000 deaths. Although gains have been achieved in the clinical management of these patients, this malignancy is rarely curable. Long-term survival is limited to patients undergoing resection. For patients with localized but unresectable malignancy, radiation therapy combined with fluorouracil, gemcitabine (Gemzar), or paclitaxel has shown modest improvements in survival and symptom palliation. However, there has been significant progress in the diagnostic evaluation of pancreatic cancer patients, which has aided clinicians in caring for these patients and in selecting therapies. The use of computed tomography, endoscopic ultrasonography, and laparoscopy techniques will be discussed. Newer techniques of radiation therapy, such as intraoperative electron-beam radiation therapy and three-dimensional conformal radiation therapy, with the integration of new biologically targeted agents may provide new avenues of research and progress in this disease.
胰腺癌仍然是肿瘤学领域一项艰巨的挑战。2003年，这种恶性肿瘤在美国是癌症死亡的第四大主要原因，估计有30,700例新病例将被诊断出来，并有30,000人死亡。尽管在这些患者的临床管理方面已取得进展，但这种恶性肿瘤很少能治愈。长期生存仅限于接受手术切除的患者。对于局部但无法切除的恶性肿瘤患者，放射治疗联合氟尿嘧啶、吉西他滨（健择）或紫杉醇已显示出在生存和症状缓解方面有适度改善。然而，在胰腺癌患者的诊断评估方面已取得重大进展，这有助于临床医生护理这些患者并选择治疗方法。将讨论计算机断层扫描、内镜超声检查和腹腔镜检查技术的应用。放射治疗的新技术，如术中电子束放射治疗和三维适形放射治疗，以及新的生物靶向药物的整合，可能为这种疾病提供新的研究途径和进展。
