Jia Yuxia, Wang Tony J C, Allendorf John, Saif Muhammad Wasif
Columbia University, College of Physicians and Surgeons and New York Presbyterian Hospital, New York, NY 10032, USA.
JOP. 2012 Mar 10;13(2):147-50.
Pancreatic adenocarcinoma is the fourth most common cause of cancer-related death among U.S. men and women. Despite much effort in translational research, pancreatic adenocarcinoma remains a challenging disease with an overall 5-year survival rate less than 5%. To date, the only potentially curative treatment for managing pancreatic adenocarcinoma is surgical resection. However, more than 80% of patients are deemed either unresectable or metastatic upon diagnosis. For borderline resectable disease, although there is no high-level evidence supporting its use, an initial approach involving neoadjuvant therapy is preferred, as opposed to immediate surgery. In this year's ASCO Gastrointestinal Cancers Symposium, several studies were presented with approaches towards treating borderline resectable pancreatic adenocarcinoma. Retrospective studies (Abstract #280, #304, #327) were presented and showed that neoadjuvant chemoradiation were associated with higher rates of negative margin resection and better survival. The tolerability of accelerated fraction radiotherapy with concomitant capecitabine was demonstrated in a phase I study (Abstract #329). More effective therapeutic approaches and prospective studies are needed for this devastating illness. This highlight article will focus on the management of borderline resectable pancreatic adenocarcinoma.
胰腺癌是美国男性和女性癌症相关死亡的第四大常见原因。尽管在转化研究方面付出了诸多努力，但胰腺癌仍然是一种具有挑战性的疾病，总体5年生存率低于5%。迄今为止，治疗胰腺癌唯一可能治愈的方法是手术切除。然而，超过80%的患者在诊断时被认为无法切除或已发生转移。对于边界可切除的疾病，尽管没有高级别证据支持其使用，但与立即手术相反，首选包括新辅助治疗的初始方法。在今年的美国临床肿瘤学会胃肠道癌症研讨会上，发表了几项关于治疗边界可切除胰腺癌方法的研究。回顾性研究（摘要#280、#304、#327）表明，新辅助放化疗与更高的切缘阴性切除率和更好的生存率相关。一项I期研究（摘要#329）证明了同步卡培他滨的加速分割放疗的耐受性。对于这种毁灭性疾病，需要更有效的治疗方法和前瞻性研究。这篇重点文章将聚焦于边界可切除胰腺癌的管理。
