School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China.
Department of Pancreatic Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.
Oncol Rep. 2021 Apr;45(4). doi: 10.3892/or.2021.7977. Epub 2021 Mar 2.
Neoadjuvant therapy (NAT) has been widely recommended for managing patients with borderline resectable pancreatic cancer and resectable tumors with high risk factors. Accurate evaluation of the response after NAT is crucial to decide surgery, which then improves the rate of R0 resection and avoids meaningless surgery. The response to NAT is currently evaluated by conventional radiological examination and changes of serum CA19‑9 levels. However, these assessments cannot accurately reflect the response to NAT. This article describes the limitations and advances of NAT response evaluation in pancreatic cancer. The values of some traditional imaging techniques, including positron emission tomography, endoscopic ultrasound, and diffusion weighted magnetic resonance imaging, are discussed, as well as novel imaging modalities or biomarkers, such as radiomics, dual energy computed tomography and liquid biopsy.
新辅助治疗（NAT）已被广泛推荐用于治疗交界可切除胰腺癌患者和具有高危因素的可切除肿瘤患者。NAT 后准确评估反应对于决定手术至关重要，这可以提高 R0 切除率并避免无意义的手术。目前，NAT 的反应通过常规影像学检查和血清 CA19-9 水平的变化来评估。然而，这些评估并不能准确反映 NAT 的反应。本文描述了胰腺癌 NAT 反应评估的局限性和进展。讨论了一些传统成像技术的价值，包括正电子发射断层扫描、内镜超声和扩散加权磁共振成像，以及新的成像方式或生物标志物，如放射组学、双能 CT 和液体活检。
