Hamad Ahmad, Crossnohere Norah, Ejaz Aslam, Tsung Allan, Pawlik Timothy M, Sarna Angela, Santry Heena, Wills Celia, Cloyd Jordan M
From the Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH.
Pancreas. 2022 Jul 1;51(6):657-662. doi: 10.1097/MPA.0000000000002083. Epub 2022 Sep 13.
Physicians are increasingly recommending neoadjuvant therapy (NT) before surgery for pancreatic ductal adenocarcinoma (PDAC). However, patient preferences for and opinions regarding NT are poorly understood.
Survivors and caregivers from a national PDAC patient advocacy organization completed an online survey assessing preferences for NT versus surgery first (SF) and factors influencing their decision making.
Among 54 participants, 74.1% had a personal history of PDAC. While most patients preferred SF for resectable disease, NT was the preferred treatment approach for borderline resectable, locally advanced, and resectable cancers with high carbohydrate antigen 19-9. The most important factor influencing patient decision making regarding NT was its impact on overall survival while the least important was published national guidelines. The most preferred rationale for NT was ability to downstage to surgical resection and early treatment of micrometastatic disease.
Among a national cohort of PDAC survivors and caregivers, the majority preferred SF for resectable PDAC, whereas NT was preferred when the resectability of a tumor was in question. The impact of NT on quantity and quality of life, as well as the likelihood of achieving surgical resection, was most highly valued by participants.
医生越来越多地建议在手术前对胰腺导管腺癌（PDAC）进行新辅助治疗（NT）。然而，患者对NT的偏好和看法却知之甚少。
来自一个全国性PDAC患者权益倡导组织的幸存者和护理人员完成了一项在线调查，评估对NT与先手术（SF）的偏好以及影响他们决策的因素。
在54名参与者中，74.1%有PDAC个人病史。虽然大多数患者对可切除疾病倾向于SF，但NT是边缘可切除、局部晚期以及伴有高碳水化合物抗原19-9的可切除癌症的首选治疗方法。影响患者关于NT决策的最重要因素是其对总生存期的影响，而最不重要的是已发布的国家指南。NT最受欢迎的理由是能够降期至手术切除以及对微转移疾病进行早期治疗。
在一个全国性的PDAC幸存者和护理人员队列中，大多数人对可切除的PDAC倾向于SF，而当肿瘤的可切除性存疑时则倾向于NT。参与者最看重NT对生活质量和数量的影响，以及实现手术切除的可能性。
