Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Anticancer Res. 2014 Sep;34(9):4673-6.
Pancreatoduodenectomy remains the recommended treatment in potentially curative strategies for pancreatic carcinoma. Due to high local failure rates even after complete resection, a multi-modality treatment approach is paramount in the management of resectable disease. Despite there being insufficient evidence to recommend a specific neoadjuvant strategy, several studies have tested the use of preoperative chemoradiotherapy in this sub-group of patients, achieving promising results. The treatment is well-tolerated, with higher rates of negative margins and lower rates of lymph node positivity at resection, a decrease in local failure and benefit in overall survival. Considering the poor oncological results after primary surgical treatment, neoadjuvant strategy should be considered as a valid alternative in resectable pancreatic carcinoma.
胰十二指肠切除术仍然是胰腺癌潜在可治愈策略的推荐治疗方法。由于即使在完全切除后局部复发率仍然很高，因此在可切除疾病的管理中，多模式治疗方法至关重要。尽管没有足够的证据推荐特定的新辅助策略，但几项研究已经在这组患者中测试了术前放化疗的使用，取得了有希望的结果。该治疗方法耐受性良好，在切除时具有更高的阴性切缘率和更低的淋巴结阳性率，降低了局部复发率，并提高了总生存率。考虑到初次手术治疗后的肿瘤学结果较差，新辅助策略应被视为可切除胰腺癌的有效替代方案。
