Regalla Dileep Kumar Reddy, Jacob Rojymon, Manne Ashish, Paluri Ravi Kumar
Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL.
Radiation Oncology, University of Alabama at Birmingham Hospital, Birmingham, AL.
Oncol Rev. 2019 Sep 10;13(2):440. doi: 10.4081/oncol.2019.440. eCollection 2019 Jul 22.
Ampullary Carcinoma arises from a histologically heterogeneous region where three different epithelia converge. Even though Ampullary Carcinoma has a superior prognosis compared to pancreatic and biliary ductal neoplasms, at least half of the patients turn up at an advanced stage that limits the treatment prospects. In addition to surgery for early-stage disease, several studies have shown that chemoradiotherapy confers additional benefits in the management of Ampullary Carcinoma. Analogously, chemotherapy plays a crucial role in treating advanced Ampullary Carcinoma with distant metastasis/recurrences. Although, stage of the disease, lymph node status, and histo-morphology are three critical prognostic variables, recently much attention is being placed on the genetic landscape of Ampullary Carcinoma. In this review, we have discussed various studies describing the role of chemoradiation and chemotherapy in the treatment of early and advanced stage Ampullary Carcinoma. Also, we have summarized the molecular landscape of Ampullary Carcinoma and the novel therapeutic strategies which could possibly target the genetic alterations involving the tumor cells.
壶腹癌起源于一个组织学上异质性的区域，该区域有三种不同的上皮细胞汇聚。尽管与胰腺癌和胆管肿瘤相比，壶腹癌的预后较好，但至少有一半的患者就诊时已处于晚期，这限制了治疗前景。除了对早期疾病进行手术外，多项研究表明，放化疗在壶腹癌的治疗中具有额外的益处。同样，化疗在治疗伴有远处转移/复发的晚期壶腹癌中起着关键作用。虽然疾病分期、淋巴结状态和组织形态是三个关键的预后变量，但最近人们对壶腹癌的基因图谱给予了很多关注。在这篇综述中，我们讨论了各种描述放化疗在早期和晚期壶腹癌治疗中作用的研究。此外，我们总结了壶腹癌的分子图谱以及可能针对肿瘤细胞基因改变的新型治疗策略。
