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[胰腺癌治疗的新进展]

[New developments in the treatment of pancreatic cancer].

作者信息

Marsman H A, Besselink M G

机构信息

Dutch Pancreatic Cancer Group.

出版信息

Ned Tijdschr Geneeskd. 2016;160:D538.

Abstract
  • The incidence of pancreatic cancer is increasing due to the ageing population among other things, while 5-year survival has improved in the past two decades from 3 to 7%.- In case of biliary obstruction due to pancreatic cancer, biliary drainage before surgery or ablative therapy using a covered metal stent instead of plastic reduces the rate of complications.- In patients with metastasized pancreatic cancer a combination of folinic acid, fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX) results in improved survival. Approximately 20% of patients with locally, unresectable pancreatic cancer can undergo surgical resection following treatment with FOLFIRINOX.- The effectiveness of radiofrequency ablation, irreversible electroporation and stereotactic radiotherapy for locally, unresectable pancreatic cancer is currently investigated in multicenter trials.- The effectiveness of neo-adjuvant chemoradiation and minimal invasive surgery in patients with resectable pancreatic cancer is currently investigated in randomized multicenter trials.
摘要
  • 胰腺癌的发病率因人口老龄化等因素而呈上升趋势,而在过去二十年中,其5年生存率已从3%提高到了7%。

  • 对于因胰腺癌导致的胆道梗阻,手术前进行胆道引流或使用覆膜金属支架而非塑料支架进行消融治疗可降低并发症发生率。

  • 对于转移性胰腺癌患者,亚叶酸、氟尿嘧啶、伊立替康和奥沙利铂联合使用(FOLFIRINOX)可提高生存率。约20%局部不可切除的胰腺癌患者在接受FOLFIRINOX治疗后可进行手术切除。

  • 目前正在多中心试验中研究射频消融、不可逆电穿孔和立体定向放射疗法对局部不可切除胰腺癌的有效性。

  • 目前正在随机多中心试验中研究新辅助放化疗和微创手术对可切除胰腺癌患者的有效性。

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