Saif Muhammad Wasif
Columbia University College of Physicians and Surgeons and Pancreas Center, New York Presbyterian Hospital. New York, NY, USA.
JOP. 2011 Mar 9;12(2):106-9.
There is no consensus on what constitutes "standard" adjuvant therapy for pancreatic cancer. This controversy derives from several studies, each fraught with its own limitations. Standards of care also vary somewhat on the geography as chemo-radiotherapy followed by chemotherapy or vice versa is considered the optimal therapy in North America (GITSG, RTOG) while chemotherapy alone is the current standard in Europe (ESPAC-1, CONKO, ESPAC-3). The high rate of locoregional failure following surgical resection for adenocarcinoma of the pancreas has made it clear that some form of adjuvant therapy should be considered in these patients. A phase II study was presented at the 2011 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium to assess the effect of the addition of algenpantucel-L immunotherapy to standard adjuvant therapy on survival in patients with resected pancreas cancer (Abstract #236). The author reviews the abstract in the context of our previous knowledge.
对于什么构成胰腺癌的“标准”辅助治疗,目前尚无共识。这一争议源于多项研究,每项研究都有其自身的局限性。护理标准在地域上也有所不同,因为在北美(胃肠道肿瘤研究组、放射肿瘤学组),化疗联合放疗后再进行化疗或反之被认为是最佳治疗方案,而在欧洲(欧洲胰腺癌研究组-1、德国胰腺癌协作组、欧洲胰腺癌研究组-3),单纯化疗是当前的标准治疗方案。胰腺癌手术切除后局部区域复发率很高,这表明这些患者应考虑某种形式的辅助治疗。在2011年美国临床肿瘤学会(ASCO)胃肠道癌症研讨会上公布了一项II期研究,以评估在标准辅助治疗中添加algenpantucel-L免疫疗法对切除胰腺癌患者生存率的影响(摘要#236)。作者结合我们之前的知识对该摘要进行了综述。