Kolbeinsson Hordur Mar, Chandana Sreenivasa, Wright G Paul, Chung Mathew
Spectrum Health General Surgery Residency, Grand Rapids, Michigan, USA.
Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA.
J Invest Surg. 2023 Dec 31;36(1):2129884. doi: 10.1080/08941939.2022.2129884. Epub 2022 Oct 3.
Pancreatic cancer is one of the leading causes for cancer-related deaths in the United States. Majority of patients present with unresectable or metastatic disease. For those that present with localized disease, a multidisciplinary approach is necessary to maximize survival and optimize outcomes. The quality and safety of surgery for pancreatic cancer have improved in recent years with increasing adoption of minimally invasive techniques and surgical adjuncts. Systemic chemotherapy has also evolved to impact survival. It is now increasingly being utilized in the neoadjuvant setting, often with concomitant radiation. Increased utilization of genomic testing in metastatic pancreatic cancer has led to better understanding of their biology, thereby allowing clinicians to consider potential targeted therapies. Similarly, targeted agents such as PARP inhibitors and immune checkpoint- inhibitors have emerged with promising results. In summary, pancreatic cancer remains a disease with poor long-term survival. However, recent developments have led to improved outcomes and have changed practice in the past decade. This review summarizes current practices in pancreatic cancer treatment and the milestones that brought us to where we are today, along with emerging therapies.
胰腺癌是美国癌症相关死亡的主要原因之一。大多数患者就诊时已处于不可切除或转移性疾病阶段。对于那些表现为局限性疾病的患者,需要采用多学科方法以最大限度地提高生存率并优化治疗结果。近年来,随着微创技术和手术辅助手段的日益采用,胰腺癌手术的质量和安全性有所提高。全身化疗也不断发展,对生存率产生了影响。目前,新辅助治疗中越来越多地使用全身化疗,通常还会联合放疗。转移性胰腺癌中基因组检测的使用增加,使人们对其生物学特性有了更好的了解,从而使临床医生能够考虑潜在的靶向治疗。同样,PARP抑制剂和免疫检查点抑制剂等靶向药物也已出现,并取得了有前景的结果。总之,胰腺癌仍然是一种长期生存率较低的疾病。然而,最近的进展已使治疗结果得到改善,并在过去十年中改变了治疗方式。本综述总结了胰腺癌治疗的当前实践以及使我们走到今天这一步的里程碑事件,同时还介绍了新兴疗法。