Pisters Peter W T, Wolff Robert A, Crane Christopher H, Evans Douglas B
The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Oncology (Williston Park). 2005 Mar;19(3):393-404, 409; discussion 409-10, 412-6.
Although in centers where pancreatectomy is performed frequently, associated morbidity and mortality rates have improved, long-term outcomes in pancreatic adenocarcinoma patients remain poor when surgery is the sole therapeutic modality. The impact of adjuvant chemotherapy on survival in patients with localized pancreatic cancer remains incompletely defined. The European Study Group for Pancreatic Cancer (ESPAC)-1 trial has suggested that overall survival rates are superior when chemotherapy is added to surgery, even when regimens believed to be relatively ineffective in the treatment of advanced disease are used. The role of radiotherapy given with chemotherapy is also unresolved, but chemoradiation continues to receive consideration in the multimodality approach to localized pancreatic cancer. Enhanced collaboration and increased involvement by pancreatic surgeons have helped in the recruitment of pancreatic cancer patients for large-scale randomized clinical trials in Europe and the United States. Many newer chemotherapeutic agents with efficacy in gastrointestinal cancers have yet to be investigated in the adjuvant and neoadjuvant settings.
尽管在经常进行胰腺切除术的中心，相关的发病率和死亡率有所改善，但对于胰腺腺癌患者而言，若手术是唯一的治疗方式，其长期预后仍然很差。辅助化疗对局限性胰腺癌患者生存的影响仍未完全明确。欧洲胰腺癌研究组（ESPAC）-1试验表明，即便使用被认为对晚期疾病治疗效果相对不佳的方案，在手术基础上加用化疗时总体生存率更高。化疗联合放疗的作用也尚无定论，但在局限性胰腺癌的多模式治疗方法中，放化疗仍在被考虑使用。胰腺外科医生加强协作并更多地参与进来，有助于在欧洲和美国招募胰腺癌患者参与大规模随机临床试验。许多对胃肠道癌症有效的新型化疗药物尚未在辅助和新辅助治疗环境中进行研究。
