Maheshwari Vivek, Moser A James
Division of Surgical Oncology, Beth Israel Medical Center, New York, NY, USA.
Nat Clin Pract Gastroenterol Hepatol. 2005 Aug;2(8):356-64. doi: 10.1038/ncpgasthep0240.
Almost 30% of patients with pancreatic cancer present with large, locally advanced tumors in the absence of distant metastases. Because surgical resection is frequently contraindicated by vascular invasion, locally advanced pancreatic cancer has a dismal prognosis with a 6-10-month median survival. Recent advances in the multimodality treatment of other gastrointestinal malignancies have not altered the management of patients with locally advanced pancreatic cancer, a clinical dilemma reflected by the number of nonrandomized trials and anecdotal reports addressing this difficult disease. Our review summarizes the current status of aggressive surgical resection and neoadjuvant chemoradiation for locally advanced pancreatic cancer and suggests a treatment algorithm for patients with this disease based upon published clinical evidence.
近30%的胰腺癌患者就诊时表现为局部晚期大肿瘤，且无远处转移。由于血管侵犯常常使手术切除成为禁忌，局部晚期胰腺癌的预后很差，中位生存期为6至10个月。其他胃肠道恶性肿瘤多模式治疗的最新进展并未改变局部晚期胰腺癌患者的治疗方式，针对这种难治性疾病的非随机试验和病例报告数量反映出了这一临床困境。我们的综述总结了局部晚期胰腺癌积极手术切除和新辅助放化疗的现状，并根据已发表的临床证据为该病患者提出了一种治疗方案。
