Rahman Sheikh Hasibur, Urquhart Robin, Molinari Michele
Department of Surgery, Dalhousie University, Halifax B3H 2Y9, Nova Scotia, Canada.
Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States.
World J Gastrointest Oncol. 2017 Dec 15;9(12):457-465. doi: 10.4251/wjgo.v9.i12.457.
The use of neoadjuvant therapies has played a major role for borderline resectable and locally advanced pancreatic cancers (PCs). For this group of patients, preoperative chemotherapy or chemoradiation has increased the likelihood of surgery with negative resection margins and overall survival. On the other hand, for patients with resectable PC, the main rationale for neoadjuvant therapy is that the overall survival with current strategies is unsatisfactory. There is a consensus that we need new treatments to improve the overall survival and quality of life of patients with PC. However, without strong scientific evidence supporting the theoretical advantages of neoadjuvant therapies, these potential benefits might turn out not to be worth the risk of tumors progression while waiting for surgery. The focus of this paper is to provide the readers an overview of the most recent evidence on this subject.
新辅助治疗在可切除边缘的胰腺癌和局部晚期胰腺癌(PC)的治疗中发挥了重要作用。对于这组患者,术前化疗或放化疗增加了手术切缘阴性和总生存期的可能性。另一方面,对于可切除的PC患者,新辅助治疗的主要理由是当前治疗策略的总生存期并不理想。人们一致认为,我们需要新的治疗方法来提高PC患者的总生存期和生活质量。然而,在没有强有力的科学证据支持新辅助治疗理论优势的情况下,这些潜在益处可能并不值得冒等待手术期间肿瘤进展的风险。本文的重点是为读者提供关于该主题的最新证据概述。