Sperti Cosimo, Pasquali Claudio, Pastorelli Davide, Ferronato Andrea, Decet Giandomenico, Pedrazzoli Sergio
Department of Medical and Surgical Sciences, University of Padova, Semeiotica Chirurgica, Ospedale Busonera, Padova, Italy.
Acta Biomed. 2003;74 Suppl 2:91-5.
The survival of patients with pancreatic cancer is dismal: tumor's resection is possible in only 10-20% of patients. This has prompted clinical studies with chemotherapy and/or radiotherapy designed to increase the number of patients eligible for surgery, to maximize local tumor control and to improve the length of survival. Since postoperative chemoradiation is often delayed in these patients due to morbidity and prolonged recovery time associated with surgery, investigators are assessing the efficacy of chemoradiation before pancreatic resection in patients with potentially resectable pancreatic carcinoma or the potential to downstage locally advanced pancreatic cancer to resectable tumor. The analysis of several clinical trials published so far shows that results are conflicting and not definitive. No randomized clinical studies have been reported. Moreover, neoadjuvant therapy rarely leads to surgical downstaging allowing for potentially curative pancreatic resections. Novel multimodality approaches are required, and patients should be entered on clinical, controlled trials.
仅10%-20%的患者可行肿瘤切除术。这促使开展了一些临床研究，采用化疗和/或放疗，旨在增加符合手术条件的患者数量，最大限度地实现局部肿瘤控制并延长生存期。由于这些患者术后放化疗常因手术相关的发病率和恢复时间延长而延迟，研究人员正在评估在潜在可切除胰腺癌患者中，或在将局部晚期胰腺癌降期为可切除肿瘤的可能性方面，术前放化疗的疗效。对目前已发表的几项临床试验的分析表明，结果相互矛盾且不明确。尚无随机临床研究报告。此外，新辅助治疗很少能使肿瘤降期从而实现可能治愈性的胰腺切除术。需要新的多模式方法，患者应参加临床对照试验。
