胰腺癌的新辅助治疗
Neoadjuvant Treatment in Pancreatic Cancer.
作者信息
Oba Atsushi, Ho Felix, Bao Quoc Riccardo, Al-Musawi Mohammed H, Schulick Richard D, Del Chiaro Marco
机构信息
Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Denver, CO, United States.
Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
出版信息
Front Oncol. 2020 Feb 28;10:245. doi: 10.3389/fonc.2020.00245. eCollection 2020.
Abstract
Thanks to the development of modern chemotherapeutic regimens, survival after surgery for pancreatic ductal adenocarcinoma (PDAC) has improved and pancreatologists worldwide agree that the treatment of PDAC demands a multidisciplinary approach. Neoadjuvant treatment (NAT) plays a major role in the treatment of PDAC since only about 20% of patients are considered resectable at the time of diagnosis. Moreover, increasing data demonstrating the benefits of NAT for borderline resectable/locally advanced PDAC are driving a shift from up-front surgery to NAT in the multidisciplinary treatment of even resectable PDAC. Our understanding of the role of NAT in PDAC has evolved from tumor shrinkage to controlling potential micrometastases and selecting patients who may benefit from radical resection. The present review gives an overview on the current literature of NAT concepts for BR/LA PDAC and resectable PDAC.
摘要
得益于现代化疗方案的发展，胰腺导管腺癌（PDAC）手术后的生存率有所提高，世界各地的胰腺病学家一致认为，PDAC的治疗需要多学科方法。新辅助治疗（NAT）在PDAC的治疗中起着重要作用，因为在诊断时只有约20%的患者被认为可切除。此外，越来越多的数据表明NAT对临界可切除/局部晚期PDAC有益，这推动了在多学科治疗中，即使是可切除的PDAC，也从直接手术转向NAT。我们对NAT在PDAC中的作用的理解已从肿瘤缩小发展到控制潜在的微转移以及选择可能从根治性切除中获益的患者。本综述概述了BR/LA PDAC和可切除PDAC的NAT概念的当前文献。
相似文献
1
Neoadjuvant Treatment in Pancreatic Cancer.胰腺癌的新辅助治疗
Front Oncol. 2020 Feb 28;10:245. doi: 10.3389/fonc.2020.00245. eCollection 2020.
2
Neoadjuvant Chemotherapy in Pancreatic Cancer: An Appraisal of the Current High-Level Evidence.新辅助化疗在胰腺癌中的应用：当前高级别证据评价。
Pharmacology. 2021;106(3-4):143-153. doi: 10.1159/000510343. Epub 2020 Sep 23.
3
Gemcitabine-Based Neoadjuvant Treatment in Borderline Resectable Pancreatic Ductal Adenocarcinoma: A Meta-Analysis of Individual Patient Data.基于吉西他滨的新辅助治疗在可切除边缘的胰腺导管腺癌中的应用：个体患者数据的荟萃分析
Front Oncol. 2020 Aug 11;10:1112. doi: 10.3389/fonc.2020.01112. eCollection 2020.
4
Surgery for Pancreatic Cancer after neoadjuvant treatment.新辅助治疗后胰腺癌的手术治疗
Ann Gastroenterol Surg. 2018 Sep 10;2(6):413-418. doi: 10.1002/ags3.12203. eCollection 2018 Nov.
5
New Frontiers in Pancreatic Cancer Management: Current Treatment Options and the Emerging Role of Neoadjuvant Therapy.胰腺癌管理的新前沿：当前治疗选择和新辅助治疗的新兴作用。
Medicina (Kaunas). 2024 Jun 28;60(7):1070. doi: 10.3390/medicina60071070.
6
Treatment of pancreatic cancer-neoadjuvant treatment in borderline resectable/locally advanced pancreatic cancer.胰腺癌的治疗——可切除边缘/局部晚期胰腺癌的新辅助治疗
Transl Gastroenterol Hepatol. 2019 May 17;4:32. doi: 10.21037/tgh.2019.04.09. eCollection 2019.
7
Predictors of Resectability and Survival in Patients With Borderline and Locally Advanced Pancreatic Cancer who Underwent Neoadjuvant Treatment With FOLFIRINOX.FOLFIRINOX 新辅助治疗后可切除性和生存预测因素分析：交界性和局部进展期胰腺癌患者
Ann Surg. 2019 Apr;269(4):733-740. doi: 10.1097/SLA.0000000000002600.
8
Intention to treat outcomes among patients with pancreatic cancer treated using International Study Group on Pancreatic Surgery recommended pathways for resectable and borderline resectable disease.采用国际胰腺外科研究组推荐的可切除和交界可切除疾病路径治疗的胰腺癌患者的意向治疗结局。
ANZ J Surg. 2021 Jul;91(7-8):1549-1557. doi: 10.1111/ans.16643. Epub 2021 Feb 12.
9
Borderline Resectable Pancreatic Cancer: Challenges for Clinical Management.可切除边缘性胰腺癌：临床管理面临的挑战
Cancer Manag Res. 2022 Dec 28;14:3589-3598. doi: 10.2147/CMAR.S340719. eCollection 2022.
10
How A Patient with Resectable or Borderline Resectable Pancreatic Cancer should Be Treated-A Comprehensive Review.可切除或边缘可切除胰腺癌患者的治疗方式——全面综述
Cancers (Basel). 2023 Aug 26;15(17):4275. doi: 10.3390/cancers15174275.
引用本文的文献
1
TREM-1 as a novel immunotherapeutic target to treat pancreatic ductal adenocarcinoma.触发受体表达于髓样细胞-1（TREM-1）作为治疗胰腺导管腺癌的新型免疫治疗靶点。
Mol Ther Oncol. 2025 Aug 14;33(3):201034. doi: 10.1016/j.omton.2025.201034. eCollection 2025 Sep 18.
2
Pancreatic cancer: a persistently challenging prognosis - a single center three-year retrospective study.胰腺癌：预后持续具有挑战性——一项单中心三年回顾性研究
Med Pharm Rep. 2025 Jul;98(3):325-332. doi: 10.15386/mpr-2848. Epub 2025 Jul 30.
3
Neoadjuvant Stereotactic Ablative Radiotherapy in Pancreatic Ductal Adenocarcinoma: A Review of Perioperative and Long-Term Outcomes.胰腺导管腺癌的新辅助立体定向消融放疗：围手术期及长期结局综述
Diseases. 2025 Jul 8;13(7):214. doi: 10.3390/diseases13070214.
4
Impact of Preoperative Diabetes on Insulin Management and Nutritional Status After Total or Completion Pancreatectomy.术前糖尿病对全胰切除术或胰体尾切除术后胰岛素管理及营养状况的影响。
Ann Surg Oncol. 2025 Jul 11. doi: 10.1245/s10434-025-17749-0.
5
Advances in neoadjuvant therapy for pancreatic cancer: Current trends and future directions.胰腺癌新辅助治疗的进展：当前趋势与未来方向。
World J Clin Oncol. 2025 Jun 24;16(6):105849. doi: 10.5306/wjco.v16.i6.105849.
6
Association Between Adjuvant Therapy and Survival in Resected Pancreatic Ductal Adenocarcinoma After Different Types and Durations of Neoadjuvant Therapy.新辅助治疗的不同类型和持续时间后，辅助治疗与切除的胰腺导管腺癌生存率之间的关联
Ann Surg Oncol. 2025 May 29. doi: 10.1245/s10434-025-17439-x.
7
Chemo- and Radiotherapy of Gastrointestinal Tumors during Pregnancy.妊娠期胃肠道肿瘤的化疗与放疗
Visc Med. 2025 Apr;41(2):64-73. doi: 10.1159/000540428. Epub 2024 Aug 22.
8
Vascular regional analysis unveils differential responses to anti-angiogenic therapy in pancreatic xenografts through macroscopic photoacoustic imaging.血管区域分析通过宏观光声成像揭示了胰腺异种移植瘤对抗血管生成治疗的不同反应。
Theranostics. 2025 Jan 27;15(6):2649-2671. doi: 10.7150/thno.99361. eCollection 2025.
9
Neoadjuvant Chemoradiotherapy Using Moderately Hypofractionated Intensity-Modulated Radiotherapy Versus Upfront Surgery for Resectable Pancreatic Cancer: A Retrospective Cohort Study.使用中度低分割调强放疗的新辅助放化疗与可切除胰腺癌的 upfront 手术对比：一项回顾性队列研究
Ann Surg Oncol. 2025 May;32(5):3603-3613. doi: 10.1245/s10434-025-16956-z. Epub 2025 Feb 1.
10
PACT-UK (PAncreatic Cancer reporting Template-UK): a cross-specialty multi-institutional consensus panel development of a standardised radiological reporting proforma for pancreatic cancer.英国胰腺癌报告模板（PACT-UK）：一个跨专业多机构共识小组制定的标准化胰腺癌放射学报告模板。
BMJ Oncol. 2023 Nov 20;2(1):e000055. doi: 10.1136/bmjonc-2023-000055. eCollection 2023.
本文引用的文献
1
Surgical indication for and desirable outcomes of conversion surgery in patients with initially unresectable pancreatic ductal adenocarcinoma.初始不可切除的胰腺导管腺癌患者中转手术的手术指征及理想结局
Ann Gastroenterol Surg. 2019 Oct 29;4(1):6-13. doi: 10.1002/ags3.12295. eCollection 2020 Jan.
2
From state-of-the-art treatments to novel therapies for advanced-stage pancreatic cancer.从最先进的治疗方法到晚期胰腺癌的新型疗法。
Nat Rev Clin Oncol. 2020 Feb;17(2):108-123. doi: 10.1038/s41571-019-0281-6. Epub 2019 Nov 8.
3
The risk of not receiving adjuvant chemotherapy after resection of pancreatic ductal adenocarcinoma: a nationwide analysis.切除胰腺导管腺癌后不接受辅助化疗的风险：一项全国性分析。
HPB (Oxford). 2020 Feb;22(2):233-240. doi: 10.1016/j.hpb.2019.06.019. Epub 2019 Aug 19.
4
Pathology of pancreatic cancer.胰腺癌的病理学
Transl Gastroenterol Hepatol. 2019 Jun 27;4:50. doi: 10.21037/tgh.2019.06.02. eCollection 2019.
5
Survival Outcomes Associated With Clinical and Pathological Response Following Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Chemotherapy in Resected Pancreatic Cancer.新辅助 FOLFIRINOX 或吉西他滨/白蛋白紫杉醇化疗后切除的胰腺癌的临床和病理反应与生存结局的相关性。
Ann Surg. 2019 Sep;270(3):400-413. doi: 10.1097/SLA.0000000000003468.
6
Role of surgical resection in the era of FOLFIRINOX for advanced pancreatic cancer.在 FOLFIRINOX 时代手术切除在晚期胰腺癌中的作用。
J Hepatobiliary Pancreat Sci. 2019 Sep;26(9):416-425. doi: 10.1002/jhbp.648. Epub 2019 Jul 24.
7
Maintenance Olaparib for Germline -Mutated Metastatic Pancreatic Cancer.维持奥拉帕利治疗种系突变转移性胰腺癌。
N Engl J Med. 2019 Jul 25;381(4):317-327. doi: 10.1056/NEJMoa1903387. Epub 2019 Jun 2.
8
Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial.氟尿嘧啶+亚叶酸、奥沙利铂和多西紫杉醇与氟尿嘧啶或卡培他滨+顺铂和表柔比星用于局部晚期可切除胃或胃食管交界处腺癌的围手术期化疗（FLOT4）：一项随机、2/3 期试验。
Lancet. 2019 May 11;393(10184):1948-1957. doi: 10.1016/S0140-6736(18)32557-1. Epub 2019 Apr 11.
9
Surgery Improves Survival After Neoadjuvant Therapy for Borderline and Locally Advanced Pancreatic Cancer: A Single Institution Experience.新辅助治疗后手术改善交界性和局部进展期胰腺癌的生存：单中心经验。
Ann Surg. 2021 Mar 1;273(3):579-586. doi: 10.1097/SLA.0000000000003301.
10
Clinical Outcomes of Conversion Surgery after Neoadjuvant Chemotherapy in Patients with Borderline Resectable and Locally Advanced Unresectable Pancreatic Cancer: A Single-Center, Retrospective Analysis.新辅助化疗后边缘可切除和局部晚期不可切除胰腺癌患者转化手术的临床结局：一项单中心回顾性分析
Cancers (Basel). 2019 Feb 26;11(3):278. doi: 10.3390/cancers11030278.
Zotero 插件