Schepis Tommaso, De Lucia Sara Sofia, Pellegrino Antonio, Del Gaudio Angelo, Maresca Rossella, Coppola Gaetano, Chiappetta Michele Francesco, Gasbarrini Antonio, Franceschi Francesco, Candelli Marcello, Nista Enrico Celestino
Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.
Department of Translational Medicine and Surgery, School of Medicine, Catholic University of the Sacred Heart of Rome, 00168 Rome, Italy.
Cancers (Basel). 2023 Jun 30;15(13):3423. doi: 10.3390/cancers15133423.
Pancreatic cancer remains a social and medical burden despite the tremendous advances that medicine has made in the last two decades. The incidence of pancreatic cancer is increasing, and it continues to be associated with high mortality and morbidity rates. The difficulty of early diagnosis (the lack of specific symptoms and biomarkers at early stages), the aggressiveness of the disease, and its resistance to systemic therapies are the main factors for the poor prognosis of pancreatic cancer. The only curative treatment for pancreatic cancer is surgery, but the vast majority of patients with pancreatic cancer have advanced disease at the time of diagnosis. Pancreatic surgery is among the most challenging surgical procedures, but recent improvements in surgical techniques, careful patient selection, and the availability of minimally invasive techniques (e.g., robotic surgery) have dramatically reduced the morbidity and mortality associated with pancreatic surgery. Patients who are not candidates for surgery may benefit from locoregional and systemic therapy. In some cases (e.g., patients for whom marginal resection is feasible), systemic therapy may be considered a bridge to surgery to allow downstaging of the cancer; in other cases (e.g., metastatic disease), systemic therapy is considered the standard approach with the goal of prolonging patient survival. The complexity of patients with pancreatic cancer requires a personalized and multidisciplinary approach to choose the best treatment for each clinical situation. The aim of this article is to provide a literature review of the available treatments for the different stages of pancreatic cancer.
尽管在过去二十年里医学取得了巨大进步，但胰腺癌仍然是一个社会和医学负担。胰腺癌的发病率正在上升，并且它仍然与高死亡率和发病率相关。早期诊断困难（早期缺乏特异性症状和生物标志物）、疾病的侵袭性及其对全身治疗的耐药性是胰腺癌预后不良的主要因素。胰腺癌唯一的治愈性治疗方法是手术，但绝大多数胰腺癌患者在诊断时已处于晚期。胰腺手术是最具挑战性的外科手术之一，但最近手术技术的改进、仔细的患者选择以及微创技术（如机器人手术）的应用显著降低了与胰腺手术相关的发病率和死亡率。不适合手术的患者可能从局部区域和全身治疗中获益。在某些情况下（例如，可行边缘切除的患者），全身治疗可被视为手术的桥梁，以使癌症降期；在其他情况下（例如，转移性疾病），全身治疗被视为延长患者生存的标准方法。胰腺癌患者的复杂性需要个性化和多学科的方法来为每种临床情况选择最佳治疗方案。本文的目的是对胰腺癌不同阶段的可用治疗方法进行文献综述。
