Murakami Yuki, Sakamoto Teruhisa, Hanaki Takehiko, Tokuyasu Naruo, Fujiwara Yoshiyuki
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Yonago Acta Med. 2023 May 10;66(2):202-207. doi: 10.33160/yam.2023.05.014. eCollection 2023 May.
Invasive pancreatic ductal carcinoma is a representative refractory malignant tumor, and even with the development of early diagnosis and treatment techniques, the treatment outcome has been remarkably poor. Surgical resection is the curative treatment for resectable pancreatic cancer and borderline resectable pancreatic cancer. However, the survival rate in patients with pancreatic cancer treated by resection alone is low because of the high postoperative recurrence rate. In this review article, we report recent studies on perioperative treatment for pancreatic cancer. Perioperative therapy is the addition of chemotherapy or radiation therapy before or after surgery to improve resectability and curative effects. Because it is difficult to cure redsecttable pancreatic cancer by surgery alone, multidisciplinary treatment combined with perioperative adjuvant chemotherapy is the current standard of care. Although perioperative chemotherapy and chemoradiotherapy have been investigated for borderline resectable pancreatic cancer, the effectiveness of preoperative treatment has not been sufficiently proven. Potentially curative pancreatic cancer is treated by surgery plus perioperative therapy; treatment cannot be either alone. We regard the successful completion of surgery and perioperative care as the key to improving treatment outcomes. Therefore, ongoing randomized controlled trials for the treatment of BR-pancreatic cancer are expected to induce further improvements survival outcomes of patients with BR-pancreatic cancer.
侵袭性胰腺导管癌是一种典型的难治性恶性肿瘤，即使早期诊断和治疗技术有所发展，治疗效果仍非常差。手术切除是可切除胰腺癌和临界可切除胰腺癌的根治性治疗方法。然而，仅接受手术治疗的胰腺癌患者生存率较低，因为术后复发率很高。在这篇综述文章中，我们报告了胰腺癌围手术期治疗的最新研究。围手术期治疗是在手术前或手术后加用化疗或放疗，以提高切除率和疗效。由于仅靠手术难以治愈可切除胰腺癌，因此联合围手术期辅助化疗的多学科治疗是目前的标准治疗方案。虽然已对临界可切除胰腺癌的围手术期化疗和放化疗进行了研究，但术前治疗的有效性尚未得到充分证实。潜在可治愈的胰腺癌通过手术加围手术期治疗；不能单独进行治疗。我们认为成功完成手术和围手术期护理是改善治疗效果的关键。因此，正在进行的治疗临界可切除胰腺癌的随机对照试验有望进一步改善临界可切除胰腺癌患者的生存结果。
