Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, United States.
World J Gastroenterol. 2020 Jan 28;26(4):375-382. doi: 10.3748/wjg.v26.i4.375.
Pancreatic ductal adenocarcinoma is an aggressive cancer with high recurrence rates following surgical resection. While adjuvant chemotherapy improves survival, a significant proportion of patients are unable to initiate or complete all intended therapy following pancreatectomy due to postoperative complications or poor performance status. The administration of chemotherapy prior to surgical resection is an alternative strategy that ensures its early and near universal delivery as well as improves margin-negative resection rates and potentially improves long-term survival outcomes. Neoadjuvant therapy is increasingly being recommended to patients with pancreatic ductal adenocarcinoma, however, patient-centered research on its use is lacking. In this review, we highlight opportunities to focus research efforts in the domains of patient preferences, patient-reported outcomes, patient experience, and survivorship. Novel research in these areas may identify relevant barriers and facilitators to the use of neoadjuvant therapy thereby increasing its utilization, improve shared-decision making for patients and providers, and optimize the experience of those undergoing neoadjuvant therapy.
胰腺导管腺癌是一种侵袭性癌症，手术后复发率很高。虽然辅助化疗可以提高生存率，但由于术后并发症或身体状况不佳，相当一部分患者无法开始或完成所有计划的治疗。在手术切除前给予化疗是一种替代策略，可确保其早期和近乎普遍的应用，并提高阴性切缘的切除率，可能改善长期生存结果。新辅助治疗越来越多地被推荐给胰腺导管腺癌患者，但缺乏针对其使用的以患者为中心的研究。在这篇综述中，我们强调了在患者偏好、患者报告的结果、患者体验和生存方面集中研究努力的机会。这些领域的新研究可能会确定新辅助治疗使用的相关障碍和促进因素，从而增加其应用，改善患者和提供者的共同决策，并优化接受新辅助治疗的人的体验。
