Garofalo Michael, Flannery Todd, Regine William
Department of Radiation Oncology, University of Maryland Medical Center, 22 S Greene Street, Baltimore, MD 21201, USA.
Best Pract Res Clin Gastroenterol. 2006 Apr;20(2):403-16. doi: 10.1016/j.bpg.2005.11.001.
Despite the best current therapies, treatment outcomes in pancreatic cancer continue to be poor. Surgery remains the single most important curative modality for the minority of patients who present with resectable disease and continues to be the cornerstone of curative-intent therapy in such patients. The value of adjuvant treatment in these patients has been the subject of much debate and has led to several phase III randomized clinical trials in both the United States and Europe. Inconsistent trial results as well as trial design critiques have led to differing conclusions with regard to the value of adjuvant chemoradiotherapy. This chapter will critically review the randomized trials that have led to this controversy and establish a rationale for the use of adjuvant chemoradiation in patients with resectable pancreatic cancer. Modern radiotherapy delivery techniques will also be discussed and future trial designs suggested.
尽管目前有最佳的治疗方法，但胰腺癌的治疗效果仍然很差。手术仍然是少数可切除疾病患者最重要的单一治愈方式，并且仍然是这类患者根治性治疗的基石。辅助治疗在这些患者中的价值一直是诸多争论的主题，并在美国和欧洲引发了多项III期随机临床试验。试验结果不一致以及对试验设计的批评导致了关于辅助放化疗价值的不同结论。本章将批判性地回顾引发这一争议的随机试验，并为可切除胰腺癌患者使用辅助放化疗建立理论依据。还将讨论现代放疗技术，并提出未来的试验设计。
