Zhonghua Wai Ke Za Zhi. 2021 Feb 1;59(2):81-100. doi: 10.3760/cma.j.cn112139-20201113-00794.
The incidence of pancreatic cancer has increased in recent years, and the mortality has ranked the third among malignant tumors. Advances have been made in the diagnosis and treatment of pancreatic cancer in the past decade, however, the current situation is still severe due to the uneven medical level in different regions of China. In 2018, Pancreatic Cancer Committee of Chinese Anti-cancer Association formulated the "Chinese comprehensive guidelines for the diagnosis and treatment of pancreatic cancer (2018 version)", with the view for standardizing and improving the level of diagnosis and treatment of pancreatic cancer in China. In 2020, the committee worked out the latest version of "Chinese comprehensive guidelines for the diagnosis and treatment of pancreatic cancer (2020 version)", based on the development in the past two years. These updates were mainly reflected in the following aspects: breakthroughs in targeted therapy and immunotherapy, and genetic screening and genetic sequencing has been firstly applied in the comprehensive diagnosis and treatment of pancreatic cancer. The practicability and accuracy of the 8th edition of AJCC-TNM staging system for pancreatic cancer has been validated in multi-center of China and has been used in clinical practice. Preoperative neoadjuvant therapy has become the standard treatment for borderline resectable and locally advanced pancreatic cancer, and it is gradually applied to the resectable pancreatic cancer. The surgical exploration after neoadjuvant therapy is particularly important. Chemotherapy-based systemic treatment modality, including targeted therapy and immunotherapy, has been carried out in clinical trial setting, and the benefits of maintenance therapy have been confirmed in advanced pancreatic cancer. The multi-disciplinary and multi-regional collaborative diagnosis and treatment pattern is widely popularized in China and runs through the entire diagnosis and treatment process. The development of domestic clinical trials and multi-center, cross-regional cooperation provides high-level evidence of evidence-based medicine for the new drug development and regimen optimization of pancreatic cancer. By incorporating the above latest advances into the new guideline, we aim to provide further guidance for the comprehensive diagnosis and treatment of pancreatic cancer in China.
近年来，胰腺癌的发病率呈上升趋势，其死亡率在恶性肿瘤中位居第三。过去十年间，胰腺癌的诊断和治疗取得了进展，然而，由于我国不同地区医疗水平参差不齐，目前的形势依然严峻。2018年，中国抗癌协会胰腺癌专业委员会制定了《中国胰腺癌综合诊治指南（2018年版）》，旨在规范和提高我国胰腺癌的诊治水平。2020年，该委员会在过去两年发展的基础上，制定了最新版的《中国胰腺癌综合诊治指南（2020年版）》。这些更新主要体现在以下几个方面：靶向治疗和免疫治疗取得突破，基因筛查和基因测序首次应用于胰腺癌的综合诊治；第8版AJCC-TNM胰腺癌分期系统在中国多中心得到验证，并已应用于临床实践；术前新辅助治疗已成为可切除边缘和局部晚期胰腺癌的标准治疗方法，并逐渐应用于可切除胰腺癌；新辅助治疗后的手术探查尤为重要；以化疗为基础的全身治疗模式，包括靶向治疗和免疫治疗，已在临床试验中开展，维持治疗在晚期胰腺癌中的益处已得到证实；多学科、多区域协作的诊治模式在我国广泛推广，并贯穿于整个诊治过程。国内临床试验的开展以及多中心、跨区域合作，为胰腺癌新药研发和方案优化提供了高质量的循证医学证据。通过将上述最新进展纳入新指南，我们旨在为我国胰腺癌的综合诊治提供进一步指导。
