*Division of Hematology-Oncology, Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO †Department of Radiation Oncology, Rush University Medical Center ‡Department of Surgery, University of Chicago Medical Center, Chicago, IL §Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX ∥Cancer and Digestive Diseases Institutes, Virginia Mason Medical Center, Seattle, WA.
Am J Clin Oncol. 2013 Dec;36(6):637-43. doi: 10.1097/COC.0b013e31823a53ce.
Concurrent chemotherapy and radiotherapy (chemoradiotherapy) for the management of pancreatic adenocarcinoma in either adjuvant or locally regional advanced settings produces predictable acute toxicities that are proportional in severity to the intensity and type of systemic therapy and to the parameters of radiotherapy. In addition, relevant to the adjuvant setting, surgery for pancreatic cancer often produces physiologic alterations that may impact a patient's ability to tolerate chemoradiotherapy. Failures to anticipate, monitor, and proactively manage the effects of surgery and toxicities of chemoradiotherapy can result in the need for unplanned treatment interruptions and/or inability to complete all planned therapy. In this review, complications of pancreatic cancer itself and of pancreatic resection as well as toxicities of chemoradiotherapy are delineated, and approaches to their management before, during, and after chemoradiotherapy are presented. Planning for the treatment of side effects before the anticancer therapy begins facilitates therapy administration and improves patient tolerance.
同步放化疗（化疗放疗）用于辅助或局部晚期胰腺癌的治疗，会产生可预测的急性毒性，其严重程度与全身治疗的强度和类型以及放疗参数成正比。此外，与辅助治疗相关，胰腺癌手术常导致生理改变，可能影响患者对化疗放疗的耐受性。未能预测、监测和积极管理手术和化疗放疗毒性的影响可能导致需要计划外的治疗中断和/或无法完成所有计划的治疗。在这篇综述中，阐述了胰腺癌本身和胰腺切除术的并发症以及化疗放疗的毒性，并介绍了在化疗放疗前、期间和之后管理这些毒性的方法。在抗癌治疗开始之前规划副作用的治疗有助于治疗管理并提高患者的耐受性。
